A 71-year-old healthy White male presented in 2010 with intermittent redness in the right eye nasally for 10 years. On examination, corrected visual acuity was 20/25 OU. Slitlamp examination revealed an elevated yellow-pink conjunctival lesion in the right eye nasally with intrinsic vascularity and hemorrhage and normal left eye (Figure, A). Conjunctival biopsy of the right eye revealed subconjunctival amyloidosis with equal staining of κ and λ light chains. Follow-up examinations showed slow disease worsening over 13 years with diffuse amyloid infiltration of the conjunctiva overhanging the cornea for 360° in both eyes (Figure, B). At last visit, the patient was asymptomatic, and corrected visual acuity was 20/50 OU. Yearly systemic monitoring for amyloidosis and serum protein electrophoresis has been negative. Limited effective treatment remains for extensive conjunctival amyloidosis as surgical debulking results in a high rate of amyloid recurrence.1,2 Conservative management with annual ophthalmic examination, ocular lubrication, and systemic monitoring was advised.
