Multiple Myeloma

Multiple myeloma is a type of cancer that affects plasma cells. Here's a breakdown of key information:

What it is:

• Multiple myeloma is a cancer of plasma cells, a type of white blood cell that produces antibodies to fight infections.
• In multiple myeloma, these plasma cells become cancerous and multiply uncontrollably in the bone marrow.
• These cancerous cells produce abnormal antibodies, known as monoclonal proteins or M proteins, which can cause various health problems.

Key aspects:

• Location: It primarily affects the bone marrow.
• Effects:
  • It can weaken bones, leading to bone pain and fractures.
  • It can impair the immune system, increasing the risk of infections.
  • It can damage the kidneys.
  • It can cause anemia and other blood problems.
• Symptoms:
  • Bone pain, especially in the back or ribs.
  • Frequent infections.
  • Fatigue.
  • Weakness.
  • Kidney problems.

Important points:

• Early detection can be challenging, as symptoms may not appear in the early stages.
• Treatment options have improved significantly in recent years, leading to better outcomes for many patients.
• Risk factors include:
  • Older age.
  • Being male.
  • Being of African American descent.
  • Having a family history of multiple myeloma.
  • Having monoclonal gammopathy of undetermined significance (MGUS).

Multiple myeloma can indeed have various effects on the eyes, though these manifestations can arise from different sources: the disease itself, or the treatments used to combat it. Here's a breakdown:

Effects from the Disease Itself:

• Hyperviscosity Syndrome:
  • Multiple myeloma produces excessive amounts of monoclonal proteins (M proteins), which can thicken the blood.
  • This increased blood viscosity can impede blood flow to the retinal blood vessels, potentially leading to:
    • Blurred vision
    • Retinal hemorrhages
    • Blind spots
    • In severe cases, vision loss.
• Direct Infiltration:
  • In rare instances, myeloma cells can infiltrate the orbit (the bony cavity surrounding the eye) or the soft tissues around it.
  • This can cause:
    • Proptosis (bulging of the eye)
    • Diplopia (double vision)
    • Eye pain or discomfort
    • Eyelid swelling
    • Reduced eye movement.
• Optic Nerve Compression:
  • In rare cases, the optic nerve may be compressed by myeloma cells or related bone lesions, resulting in:
    • Decreased visual acuity
    • Visual field defects
    • Changes in color vision.

Effects from Treatment:

• Cataracts:
  • Long-term use of corticosteroids (like dexamethasone) increases the risk of cataracts.
• Dry Eyes:
  • Chemotherapy and stem cell transplantation can reduce tear production, leading to dry eye syndrome.
• Corneal Damage (Keratopathy):
  • Certain medications can cause corneal damage, resulting in eye pain, irritation, and vision changes.
• Eye Infections:
  • Multiple myeloma and its treatments weaken the immune system, making patients more susceptible to eye infections like conjunctivitis.

Key Recommendations:

• Regular Eye Exams: Patients with multiple myeloma should undergo regular eye examinations to monitor for any potential complications.
   
  If you or someone you know is experiencing symptoms that might indicate multiple myeloma, it's crucial to consult with a healthcare Clinic or Hospital for proper diagnosis and treatment.

Author

Paddy Kalish OD, JD and B.Arch