This document presents a case of a 48-year-old African American female who presented with sudden decreased vision in her right eye over 5 days. Examination revealed signs of optic neuropathy in the right eye including decreased vision, color plate errors, and disc edema. Imaging and biopsy results showed enlarged lymph nodes and noncaseating granulomas consistent with sarcoidosis. Sarcoidosis can cause ocular involvement including uveitis, conjunctival granulomas, and optic neuropathy through infiltration or compression of the optic nerve. Treatment involves corticosteroids and immunosuppressants to manage systemic disease.

1. Doheny Eye Institute Lauren Patty, MD

10. Chest CT Enlarged bilateral hilar, R paratracheal, and subcarinal LNs. Several tiny scattered noncalcific R lung nodules, hazy LLL opacities. C/w sarcoidosis. Bronchoscopy results: reactive process, no malignant cells, AFB and fungal cx negative

11. Biopsy Conjunctival biopsy: + for noncaseating granulomas

15. Ocular Sarcoidosis Mutton-fat KPs Koeppe nodules Busacca nodules Vitritis – “snowballs”

16. Ocular Sarcoidosis Sea fans Candlewax drippings