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Sarcoidosis presenting as multilobular limbal corneal nodules
S M Hegab1, S A al-Mutawa, S M Sheriff
1Eye Department, Ibn-Sina Hospital, Kuwait.
Journal of Pediatric Ophthalmology and Strabismus
|December 16, 1998
Summary
This study presents a unique case of ocular sarcoidosis presenting as bilateral limbal nodules in a young girl. The findings highlight the diverse external eye manifestations of sarcoidosis.
Area of Science:
- Ophthalmology
- Dermatology
- Immunology
Background:
- Sarcoidosis is a multisystem granulomatous disease with varied ocular manifestations.
- External ocular involvement in sarcoidosis, though less common, can present with diverse clinical features.
Observation:
- A 16-year-old female presented with bilateral, multilobular, limbal nodules and conjunctivitis, alongside signs of healed trachoma.
- Ocular findings included reduced tear production (Schirmer's test < 2 mm) and a small tear meniscus (< 2 mm).
Findings:
- Biopsy of a conjunctival nodule revealed a noncaseating granulomatous reaction, confirming sarcoidosis.
- Gallium scan indicated uptake by both lacrimal glands, while chest X-ray and serum angiotensin-converting enzyme (SACE) levels were normal.
- Beta-hemolytic streptococci were identified on culture, suggesting superimposed infection.
Implications:
- This case underscores the importance of considering sarcoidosis in the differential diagnosis of unusual external ocular lesions.
- The presentation of limbal nodules represents a unique external ocular manifestation of sarcoidosis.
- Early recognition and diagnosis of ocular sarcoidosis are crucial for appropriate management and prevention of vision-threatening complications.