The Inflammatory Dilemma: A Unique Case of Ocular Sarcoidosis and The Road to Diagnosis and Management

Abstract

Introduction Sarcoidosis is an inflammatory condition that affects several organ systems. The eye is affected in approximately 30-60% of people with sarcoidosis, with uveitis being the most frequent ocular manifestation.1 The diagnosis of ocular sarcoidosis in the absence of systemic manifestations is challenging due to it mimicking other uveitic conditions, and lab work often being non-specific. Case Report A 38-year-old African American male presented with a chief complaint of blurry vision and a sensation of pressure behind his left eye, denying pain. Bilateral anterior non-granulomatous uveitis was diagnosed and treated accordingly. The patient had several episodes of recurrent uveitis prompting a full infectious and inflammatory work-up. He subsequently suffered from systemic-related symptoms and was eventually diagnosed with sarcoidosis based on lung biopsy and neuroimaging. Ocular history, imaging, lab-work, and a multidisciplinary approach was used to confirm the diagnosis of sarcoidosis. Conclusion Sarcoidosis is a condition which predominantly affects the lungs and can have extrapulmonary manifestations. Any part of the eye and adnexa can be involved either in isolation or simultaneously, with uveitis being the most common manifestation. The goal of treatment of sarcoid associated uveitis is controlling the inflammation to prevent permanent ocular damage and vision reduction sequelae. Patients with ocular sarcoidosis should be monitored by their primary care doctor and referred to the appropriate specialties for possible systemic manifestations.