J Korean Ophthalmol Soc.  2023 Sep;64(9):854-858. 10.3341/jkos.2023.64.9.854.

Unilateral Eyelid Swelling Secondary to Local Palpebral Conjunctival Amyloidosis in a Young Patient

• Shin H
• Seo Y
• Jung JW

• KMID: 2545763
• DOI: http://doi.org/10.3341/jkos.2023.64.9.854

Abstract

Purpose
We report a young patient with unilateral eyelid swelling secondary to local, palpebral conjunctival amyloidosis.
Case summary
A 31-year-old male was referred with a 6-month history of mild, right upper eyelid swelling but without redness or tenderness. Slit-lamp examination revealed a diffuse hemorrhagic papilliform lesion on the right upper palpebral conjunctiva, this raised a suspicion of giant papillary conjunctivitis. As the lesion was unilateral, there was no history of allergic disease or contact lens use, and the lesion was refractory to topical anti-inflammatory treatment so, excisional biopsy of the right upper palpebral conjunctiva was performed. During the operation, the papilliform lesion was removed, it peeled off on the blade. After surgery, the eyelid swelling improved. Histopathological examination revealed an eosinophilic amorphous deposit consistent with amyloidosis. Further evaluation ruled out systemic amyloidosis; there were no abnormal findings. Thus, we diagnosed primary localized amyloidosis of the palpebral conjunctiva. At the 1-year follow-up, no recurrence was detected.
Conclusions
Although primary localized amyloidosis of the palpebral conjunctiva is rare, this should be considered if chronic eyelid swelling accompanied by another conjunctival lesion such as giant papillary conjunctivitis is encountered.

Keyword

Amyloidosis, Eyelid swelling, Giant papillary conjunctivitis, Palpebral conjunctiva, Primary amyloidosis