Smoldering Multiple Myeloma
A patient with past medical history of alcoholic cirrhosis presents with bilateral progressively worsening vision for the last two years. He had previously been diagnosed with Fuch’s corneal dystrophy. His visual acuity measures 20/250 in the right eye and 20/200 in the left eye. His central corneal thickness is measured to be 529μm in the right eye and 522μm in the left eye. On slit lamp examination, he is found to have bilateral central posterior stromal haze without corneal edema. Anterior segment OCT reveals hyperreflective posterior corneal stroma. Lab work was recommended, which revealed a microcytic anemia and elevated free kappa/lambda light chain with elevated IgG level. On hematology evaluation, he underwent bone marrow biopsy which revealed smoldering multiple myeloma. Hematology recommended treatment given corneal opacities causing decreased vision.
Presentation Date: 04/09/2026
Issue Date: 04/10/2026
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