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Amyloidosis of the conjunctiva.

BACKGROUND
Amyloid of the eyelid conjunctiva is an extremely rare condition which may result in chronic discomfort and multiple surgeries.


METHODS
A retrospective study of four patients from Moorfields Eye Hospital is presented to assess the clinical features and results of surgical treatment.


RESULTS
Three patients had persistent ocular irritation and required multiple surgical procedures for recurrent amyloid. However, one patient has been followed for nearly 30 years with relatively few symptoms, and has required only infrequent surgical intervention. All patients underwent debulking and ptosis surgery at least once. The more severe clinical course was not related to the type of amyloid protein present. Shave excision of recurrent tarsal conjunctival amyloid with split-thickness mucous membrane grafting was successfully tried in one patient in order to minimise postoperative cicatrisation of the posterior lamella.


CONCLUSION
The clinical course of patients with eyelid amyloid may vary greatly. Management should be conservative when possible, but surgery is an integral part of management since debulking of amyloid deposits and ptosis surgery was required in all patients in this series.