Histopathologic examination of conjunctival tophi in gouty arthritis.

PURPOSE: To report a case of conjunctival tophi in a 59-year-old woman with gouty arthritis.

DESIGN

Observational case report.

METHODS

A 59-year-old woman with a 25-year history of severe gouty arthritis presented with bilateral chalky white conjunctival deposits. Conjunctival biopsies were obtained, and light and electron microscopy studies were performed.

RESULTS

Light microscopy confirmed multiple gouty tophi. Transmission electron microscopy revealed intracytoplasmic crystalline deposits within histiocytes. Extracellular aggregates of the crystalline deposits were enclosed by membranous material.

CONCLUSIONS

Conjunctival crystals may aid in identifying undiagnosed patients. In addition to conjunctival tophi, patients may also have uveitis, corneal crystals, and band keratopathy.