Interstitial keratitis as presenting ophthalmic sign of sarcoidosis in a child

Interstitial keratitis is a rarely occurring sign in sarcoidosis. We report a case of childhood sarcoidosis with initial ocular presentation as interstitial keratitis. Erythema nodosum preceded the ocular findings by 4 years and arthritis developed 1 year after ocular findings developed. Although no history of intraocular inflammation was present, there was evidence of inactive chorioretinitis and vitritis found at initial presentation. Systemic steroids were used to treat the patient's skin lesions and topical steroids to treat his corneal inflammation. He developed posterior uveitis and optic nerve edema both of which were responsive to oral steroids. Two years after the presentation of his ocular findings, the onset of pulmonary symptoms and resultant transbronchial biopsy confirmed his diagnosis of sarcoidosis.