Crystalline keratopathy associated with monoclonal gammopathy of undetermined significance

摘要

This otherwise healthy 81-year-old woman was noted at a routine ophthalmology appointment to have small crystalline deposits evenly distributed throughout the anterior corneal stroma of both eyes (image). She did not report any visual symptoms and her visual acuity remained unchanged at 6/9 in both eyes. The ocular examination was otherwise normal. She presented a year later to her general practitioner with fatigue. Serum electrophoresis demonstrated an IgG kappa paraprotein at a concentration of 17-2 g/1. She was referred to the haematology service and a bone marrow biopsy demonstrated a plasma cell infiltrate of 2%.