Primary localized conjunctival amyloidosis presenting with recurrence of subconjunctival hemorrhage

PURPOSE: To report the ocular presentation and histopathology of a patient with primary localized conjunctival amyloidosis. METHODS: A 38-year-old woman presented with a recurrence of episodes of sev ere bilateral subconjunctival hemorrhage, Ocular examination revealed yello wish, marked folding and redundancy of the conjunctiva in the inferior cul- de-sac of each eye. RESULTS: After two initial conjunctival biopsies that showed only chronic i nflammation, a third biopsy revealed the presence of amyloid in the substan tia propria of the conjunctiva. CONCLUSION: Primary localized conjunctival amyloidosis is rare and usually diagnosed histologically instead of clinically. Recurrence of subconjunctiv al hemorrhage may be the initial presentation. Evaluation for systemic dise ases is advised, though the results of the examination are almost always ne gative. (Am J Ophthalmol 2000;129:245-247. (C) 2000 by Elsevier Science Inc . All rights reserved.).