Hyperviscosity Retinopathy and Immunogammopathy Maculopahy as New Onset of Multiple Myeloma.

The purpose is to report a case of immunogammopathy maculopathy and hyperviscosity retinopathy as the presenting feature of new-onset multiple myeloma (MM) in an otherwise healthy man. A 50-years-old man presented with painless visual changes in both eyes for 2 months. Ocular examination revealed bilateral CRVO-like associated with macular edema (ME) and an inferior serous detachment. Hematologic investigation revealed an increased percentage of plasma cells in the bone marrow, reaching the diagnosis of MM IgM/kappa. Clinical support and chemotherapy effectively improved ocular alterations, despite the residual ME. Injection of triamcinolone was carried out, without any response. Bilateral vision reduction with hyperviscosity syndrome-related retinopathy and immunogammopathy maculopathy was the first manifestation of an underlying systemic and potentially fatal disease. This case highlights the need for diligent and thorough investigations for less common systemic conditions associated with retinal vein occlusions.

Iatrogenic corneal diseases or conditions.

Any prescribed or self-administered therapy carries inherent risks of secondary adverse events. While the volume of treatments being administered through healthcare systems has been increasing, scientific advancements in our understanding of the mechanisms of pharmaceutical side effects and complications from procedures now allow us to reduce the risk of non-intentional damage to ocular health. This review summarizes the most common and leading causes of iatrogenic visual impairment, corneal diseases, and conditions that present in a general ophthalmologic practice, including a comprehensive analysis of their pathophysiology and recommendations for management and prophylaxis.Iatrogenic corneal diseases and conditions can arise from topical drugs, contact lens use, eye surgeries and procedures, systemic drugs, non-ophthalmological events, and cosmetic procedures. Topical and systemic drugs may disturb tear film homeostasis or result in ocular surface deposits. The use of ill-fitted contact lenses can trigger eye discomfort and poor hygiene conditions that can predispose to severe infections. Procedures to the eye may result in a variety of anatomical and functional complications that ophthalmologists should be aware of how to avoid or at least be prepared to manage if they occur. Even non-ophthalmological events such as non-invasive ventilation, radiation therapies and, immune-based conditions, or cosmetic procedures such as eyelash growth and fillers, can result in unwanted damage to the ocular surface.