Paraproteinemic Keratopathy: Recognizing the Ocular Significance

Paraproteinemic keratopathy, linked to conditions like multiple myeloma and MGUS, can cause significant visual impairment or be asymptomatic. This study discusses 3 new cases and 2 follow-ups, showing varied treatment responses including chemotherapy, superficial keratectomy, and PKP, with chemotherapy sometimes resolving corneal crystals. Long-term follow-up is essential as keratopathy can precede systemic symptoms and recur. The term "monoclonal gammopathy of ocular significance" is proposed to reflect its impact. Treatment decisions should balance symptom severity, treatment side effects, and patient preferences, highlighting the need for prospective multicenter studies and collaboration between specialists.