AMYLOIDOSIS OF THE CONJUNCTIVA

Background: Amyloid of the eyelid conjunctiva is an extremely rare con dition which may result in chronic discomfort and multiple surgeries. Methods: A retrospective study of four patients from Moorfields Eye Ho spital is presented to assess the clinical features and results of sur gical treatment.Results: Three patients had persistent ocular irritati on and required multiple surgical procedures for recurrent amyloid. Ho wever, one patient has been followed for nearly 30 years with relative ly few symptoms, and has required only infrequent surgical interventio n. 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 amyl oid with split-thickness mucous membrane grafting was successfully tri ed in one patient in order to minimise postoperative cicatrisation of the posterior lamella. Conclusion: The clinical course of patients wit h eyelid amyloid may vary greatly. Management should be conservative w hen possible, but surgery is an integral part of management since debu lking of amyloid deposits and ptosis surgery was required in all patie nts in this series.