Asymptomatic ocular sarcoidosis

Sarcoidosis, as multisystem disease, may affect the entire visual apparatus and its adnexa: the eye hence is an optimal observation point to confirm diagnosis and assess disease activity. However, the eyes are affected only in one-fourth of cases, and the majority of the lesions are asymptomatic, requiring appropriate examination techniques to be detected. In this paper we reviewed the ophthalmic changes found in a group of 163 Italian patients affected with sarcoidosis, comparing the data collected with those published in the literature. Conjunctival granulomata, chorio-retinal lesions and lacrimal gland involvement were the more common ocular manifestations of the sarcoidosis detected; these were asymptomatic in two patients out of three. Ocular changes in sarcoidosis are more common than generally appreciated even in white patients, but their detection requires meticulous eye examination, the use of 67 Gallium scans of the head, fluorangiography, and the yield of biopsies from available eye tissues.