Clinical Image: Bilateral black eyes (raccoon's eyes) in AL amyloidosis


The patient, a 51-year-old woman, had noted the development of orbital signs ∼1 year before she was diagnosed as having AL amyloidosis. Also known as raccoon's eyes, this has been described to occur in association with a few diseases, primary amyloidosis and multiple myeloma among them. Raccoon's eye is a consequence of vascular fragility induced by the deposition of amyloid and is sometimes associated with abnormal clotting, which can also occur in AL amyloidosis (1–3). 1

Illustration 1.