Ocular Manifestations of Sarcoidosis

Sarcoidosis is a complex granulomatous systemic inflammatory disease that can affect the eye and its adnexa. Ocular sarcoidosis is a leading cause of inflammatory eye disease that can result in significant visual impairment. Ocular inflammation can manifest with a wide range of clinical presentations and can involve almost any structure within or around the orbit causing uveitis, episcleritis/scleritis, eyelid anomalies, conjunctival granulomas, optic neuropathy, lacrimal gland enlargement, glaucoma, and/or cataract. The diagnosis of ocular sarcoidosis is typically established based on the presence of characteristic ophthalmologic findings, along with a positive tissue biopsy or bilateral hilar adenopathy on chest imaging. Topical, periocular, and systemic corticosteroids are commonly used to treat ocular sarcoidosis. Chronic cases or refractory cases may warrant immunomodulator therapy. Visual prognosis is contingent on severity of inflammation, time to treatment, and secondary ocular complications. This chapter will discuss the presentation, diagnosis, treatment, and prognosis of patients with ocular sarcoidosis.