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The ophthalmic manifestations of a 51-year-old man with multiple myeloma included exudative retinal detachments and multiple epibulbar plasmacytomas. The retinal changes resolved with treatment for systemic effects, and the IgA-producing plasmacytomas rapidly resolved with local irradiation. The young age of onset (37 years), the prolonged course (14 years), and the IgA M protein and epibulbar involvement were, collectively, unusual findings in multiple myeloma. The presence of epibulbar, gastrointestinal tract, and prostate involvement suggested a homing mechanism of IgA-committed cells to mucosal surfaces.
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