Multiple myeloma is characterized by the neoplastic proliferation of a single clone of plasma cells. Multiple myeloma rarely involves the eyeball or the orbital tissues. We report a case of multiple myeloma that presented with corneal crystalline depositions in a patient complaining of decreased vision and irritation of both eyes without any systemic symptoms.

A 63-year-old woman complained of decreased vision and irritation of both eyes that had started suddenly 20 days before. Uncorrected visual acuity was 0.2 in the right eye and 0.3 in the left eye. Best-corrected visual acuity (BCVA) was 0.9 in the right eye and 1.0 in the left eye. Slit lamp examination showed gray-white crystalline depositions on the epithelium, stroma and Descemet membrane of the cornea extensively, except for the limbus. There were no specific findings on intraocular pressure measurement and fundus examination. The patient did not complain of any systemic symptoms. Multiple myeloma was diagnosed by blood examination and bone marrow biopsy. Two months later, the BCVA decreased to 0.3 in both eyes and artificial tears were prescribed to relieve irritation.

When irritation and decreased vision occur abruptly even without systemic symptoms, there is a possibility of multiple myeloma. Systemic evaluations are needed in these cases.