Peripheral ulcerative keratitis associated with multiple myeloma.

Clinical Picture A 66-year-old lady with known MM presented with red painful right eye and reduced vision, with no ocular discharge. At the point of presentation, she had been diagnosed with MM for 2 months. She did not suffer from auto-immune diseases. Systemic examination was unremarkable. Blood test for rheumatoid factor, pANCA, cANCA, ANA and dsDNA were negative. Inflammatory markers were not elevated. Visual acuity was counting fingers (CF) in the affected eye. Ocular examination revealed an injected right eye with a punched-out and undermined perilimbal corneal epithelial defect and thinning at 5 o’clock position, with stromal infiltrates (Fig. 1).