Bright Sight

Oliver Backhouse, Consultant Eye Surgeon www.cataract.org.uk

Sarcoidosis

Sarcoidosis is a condition of unknown cause that can produce inflammation in any part of the body. It can show itself in many different ways. Some people feel lethargic, weak and may loose weight. Others can have a cough with shortness of breath. Some can have night sweats and fevers. Others may develop swollen glands or a skin rash. One in 5 people with sarcoidosis will present with an eye problem first and so the condition may be diagnosed after seeing an ophthalmologist.

Sarcoidosis is a very variable disease. It may only involve the eye but some people will have several different problems at once. It can start abruptly or be of a more gradual onset and likewise symptoms and signs can go away slowly or rapidly. Some people need very little treatment (if any at all), but a few need to take long term drugs to control the inflammation.

Over 20% of people with sarcoidosis develop eye involvement. Uveitis is inflammation inside the eye which can cause a variety of problems. In some people, one or both eyes get red and sore. In others there is a gradual blurring of vision. The treatment of uveitis depends on which part off the eye is affected. Many patients will only need steroid eye drops to control the inflammation. Other eye drops may also be necessary. If severe inflammation at the back of the eye is in danger of damaging the vision, it will be necessary to use a steroid tablet Prednisolone. An information sheet on Prednisolone is available from the uveitis clinic.

If sarcoidosis is suspected, blood tests and a chest X-ray may help confirm the diagnosis. Other tests are occasionally needed in addition. There is no one test which is absolutely diagnostic of sarcoidosis and most often the diagnosis is ‘presumed’ rather than proven.

Lung involvement is common in sarcoidosis. Inflammation here may not cause symptoms, or may cause breathlessness or cough. If such inflammation goes untreated, it can lead to permanent changes. If any lung or generalised inflammation is found we will arrange for you to see a physician who may carry out further tests and decide whether any treatment is required. As sarcoidosis can affect many parts of the body it may be necessary to see more than one hospital specialist, each of whom has expertise in a particular field. The best treatment for the sarcoidosis may be needed to be decided jointly.

If sarcoidosis does cause uveitis, that inflammation can go away in a few months, but more commonly persists for longer than that. Both eyes are affected although one may be worse than the other. The severity of inflammation varies from very mild to the very severe so the treatment and frequency of visits will vary accordingly.

If the uveitis in sarcoidosis is severe or prolonged, other eye problems such as glaucoma (raised pressure in the eye) and cataract (clouding of the lens in the eye) can develop.