Conjunctival amyloidosis: is it related to trachoma?

Due to presence of trachoma in a large percentage of cases of conjunctival amyloidosis, trachoma has been blamed for causing secondary localized amyloidosis. However, there is no study to demonstrate evidence of amyloidosis in tarsoconjunctival specimens of trachomatous lids. 50 eyes of 35 patients having trachomatous eyelids with thickened tarsal plate, trichiasis and entropion had a tarsoconjunctival biopsy (3 mm x 20 mm) from the upper lid. Histopathological examination using Haematoxylin--eosin and congo red stains failed to reveal evidence of amyloid deposition in any of the biopsies. This is the first histopathological study of amyloidosis in trachomatous patients. Our study rules out the long-standing concept of trachoma having causal relationship with conjunctival amyloidosis. It is concluded that conjunctival amyloidosis occurring in trachomatous lids should be considered as primary localized amyloidosis.