Ocular Sarcoidosis: Everything to Know

Sarcoidosis is a disease that causes small masses of tissue clumps, called granulomas, to form inside the body. These granulomas can lead to damaged or malfunctioning organs in the body and frequently involve the eyes.

Uveitis (inflammation inside the eyes) is the most serious manifestation of ocular sarcoidosis, or sarcoidosis in the eyes. Uveitis causes eye pain, redness, and vision loss and must be treated immediately with steroids by an ophthalmologist.

In this article, you'll learn what to expect with ocular sarcoidosis, including the symptoms, diagnosis, causes, and treatment for the condition.

Ocular Sarcoidosis Symptoms

It's very common for sarcoidosis to affect the eyes. Anywhere from 25% to 80% of sarcoidosis patients have symptoms that affect the eyes at some point.

Many of these patients complain of burning, itching, redness, dry eyes, and watery eyes. Some patients report blurred vision and may complain of sensitivity to sunlight. Sarcoidosis patients also have small, pale yellow bumps on the eye.

Depending on where the inflammation occurs within the eye, the following symptoms may develop:

• Dry eyes
• Itchy, burning eyes
• Red and sometimes painful eyes
• Blurred vision
• Seeing black spots or strings
• Sensitivity to light
• Reduced color vision

Causes

Sarcoidosis is a disease that may affect many body organs but mainly affects the lungs. The condition usually occurs in adults 20 to 40 years of age.

Some people develop uveitis as a complication of sarcoidosis. Uveitis is an inflammation of the uvea, or blood-rich membranes in the eye. The uvea is in the center of the eye, between the sclera and the retina.

In uveitis, white blood cells rush to the front of the eye and make the eye very sticky. This stickiness can cause internal structures, like the iris and lens, to stick together. This can result in increased eye pressure.

Patients may complain of pain in their eye, redness, and mild to extreme light sensitivity. Although rare, blindness may occur if the uveitis is left untreated.

Diagnosis

An ophthalmologist will examine the front part of your eye with a lighted microscope. They will dilate your pupils with dilating drops to see the back of the eyes. The doctor will look for any signs of inflammation.

Since dry eyes are common with sarcoidosis, they will evaluate the tear-producing lacrimal glands using the Schirmer test. The Schirmer test uses blotting paper to measure the moisture (tears) produced by the lacrimal gland in the lower eyelid.

Treatment

Sarcoidosis eye treatment depends on the area of the eye affected. Your ophthalmologist may prescribe:

• Anti-inflammatory eye drops to reduce inflammation
• Dilating drops to prevent adhesion of the iris to the lens
• Artificial tears to treat the drying of the lacrimal glands
• Corticosteroid treatment (tablets taken orally) can be effective in stubborn cases

Coping

Since eye problems are common with sarcoidosis, it is important to detect them early. Proper monitoring and treatment can slow or prevent permanent damage. Sarcoidosis patients should see an eye doctor at least once per year to check for complications.

A Word From Verywell

Sarcoidosis most often affects the lungs, lymph nodes, and liver. But it can also cause problems with the eyes, spleen, brain, nerves, heart, tear glands, salivary glands, sinuses, bones, and joints.

If you're diagnosed with sarcoidosis, plan to have an annual comprehensive eye examination by an optometrist or ophthalmologist for the first few years after diagnosis. Then, you can go as needed.