Ocular involvement is seen in around 12% of patients with sarcoidosis (1). Anterior or posterior segment of the eye can be involved. In around 10-15% of uveitis patients, involvement of both the anterior and posterior segments can be observed (2).
- anterior uveitis -
- is the commonest ocular manifestation seen in around 65% of patients with ophthalmologic involvement
- chronic anterior uveitis is more common than acute anterior
- acute uveitis - this is the most common ocular manifestation usually occurring in association with erythema nodosum and bilateral hilar lymphadenopathy. It is generally a benign condition and responds well to therapy, usually resolving within a year
- chronic uveitis - leads to glaucoma and vision loss, may occur with lupus pernio, bone cysts and pulmonary fibrosis. This may also respond to corticosteroid therapy.
- posterior uveitis -
- seen in around 30% of patients with eye sarcoidosis (2)
- may not have any symptoms (1)
- frequently there is associated central nervous system involvement (2)
- keratoconjunctivitis sicca - this may occur with or without parotid and lacrimal gland involvement.
- Heerfordt's syndrome (Uveoparotid fever) - includes a combination of uveitis, parotid gland enlargement, and facial nerve palsy (1).
Note that uveitis is more common in women than men.
Resolution of acute anterior uveitis may be spontaneous or after treatment with topical corticosteroids. Systemic steroid therapy is usually indicated in posterior uveitis, optic neuritis or in uveitis resistant to topical agents (2,3).
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