Purpose: To describe ophthalmic manifestations in a series of patients with multiple myeloma (MM) and review the literature. Design: Retrospective case series. Methods: Review of all cases with ophthalmic manifestations of MM seen at the Department of Ophthalmology, Royal Adelaide Hospital, between 1987 and 2002. Results: Of all patients with MM who were managed at the Royal Adelaide Hospital in the study period, only 8 were referred to the Ophthalmology Department with ophthalmic manifestations. Five males and 3 females with a mean age of 61.25 years (range 42–78) who exhibited ophthalmic manifestations were studied. Six patients (75%) had known MM at the time of their ophthalmic evaluation. Four patients (50%) had neuro-ophthalmic symptoms resulting in diplopia or visual disturbances. Three patients (37.5%) presented with orbital involvement and 1 (12.5%) with hyperviscosity retinopathy. Five patients (62.5%) died within 2 months of their ophthalmic presentation. Conclusion: Ophthalmic manifestations of MM are uncommon and diverse. They may appear at the initial presentation of the disease or occur late in the disease process. Awareness of the possible manifestations may lead to an earlier diagnosis and have a positive influence on the disease course.

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Purpose: To present our experience with a series of patients treated with deep lamellar keratoplasty (DLK) for keratoconus (KC). Design: A single surgeon, prospective, consecutive series.Method: The study included all patients with KC who underwent DLK between March 1999 and November 2003 at the Royal Adelaide Hospital. The parameters evaluated included patients’ demographics, pre- and post-operative best corrected visual acuities, post-operative keratometry, and intra- and post-operative complications. Results: There were 22 patients (23 eyes); 10 females and 12 males, with a mean age of 35 ± 13 years (median, 33.5; range, 17–73). The median follow-up period was 13 months (range 7–38). In 89% (16/18) of eyes which underwent DLK, and in which a visual acuity could be obtained, a best corrected visual acuity of at least 6/12 was recorded. There were two episodes of Descemet’s membrane perforation (8.7%), in which the procedure was converted to penetrating keratoplasty without complications. One patient developed a double anterior chamber, which resolved spontaneously without consequences. Conclusion: The visual outcomes and complication rates seen in our series are comparable to the recent published literature. Hence DLK can be considered as a suitable alternative to penetrating keratoplasty for the surgical treatment of KC.