OCULAR MANIFESTATIONS OF SARCOIDOSIS Dr.ADNAN MATHEEN PG Dept of OPHTHALMOLOGY

SARCOIDOSIS can involve ANY PART of the EYE and may be the MAJOR Manifestation of the Disease, Even Leading to Severe Impairment. OCULAR INVOLVEMENT– 30% Most commonly seen in BLACK PEOPLE

SYMPTOMS BLURRED VISION PHOTOPHOBIA FLOATERS REDNESS PAIN DRY EYES LACRIMAL GLAND ENLARGEMENT

SIGNS CONJUNCTIVAL NODULES IRIS NODULES ANTERIOR UVEITIS POSTERIOR SYNECHIAE PERIPHELBITIS CYSTOID MACULAR EDEMA

CONJUNCTIVAL NODULES

IRIS NODULES

POSTERIOR SYNECHIAE

KERATIC PRECIPITATES ‘MUTTON FAT’ because they are Large and Greasy

FUNDUS Posterior segment lesions (20%) Patchy Venous Sheathing Cellular infiltrate around Vessels CHORIORETINAL GRANULOMAS Vasculitis including Occlusive causing:- Neovascularisation Infiltrate in Vitreous (Vitritis) including Cell Clumps (Snowballs)

PUNCHED OUT

CANDLE WAX DRIPPING

Sheathing of the Retinal Veins Fluorescein Angiography showing LEAKAGE and Staining at Sites of Sheathing

Granuloma in Fundus OPTIC NERVE HEAD GRANULOMA Normal Optic Nerve Head

INVESTIGATIONS BIOPSIES OF CONJUNCTIVA LACRIMAL GLAND

TREATMENT CYCLOPLEGICS Tropicamide Cyclopentolate Homatropine 2% TOPICAL STEROIDS ORAL STEROIDS CYTOTOXIC DRUGS

MIKULICZ SYNDROME ENLARGEMENT OF LACRIMAL GLAND PAROTID GLAND SALIVARY GLAND DRY EYES

POINTS TO REMEMBER IRIS NODULES PAN UVEITIS POSTERIOR SYNECHIAE MUTTON FAT KP’s CANDLE WAX DRIPPINGS STEROIDS

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