Conjunctival biopsy in the diagnosis of sarcoidosis.
The diagnosis of sarcoidosis with ocular involvement is often difficult and accompanied by a certain measure of uncertainty due to a paucity of additional physical signs. In the ophthalmic literature, it is controversial as to whether biopsy of a clinically normal conjuctiva should be done if sarcoidosis is suspected. Many authors advocate biopsy only in the presence of conjunctival follicles or nodules. However, a positive biopsy from a clinically normal-appearing conjunctiva has been reported. Recently, we saw a patient with bilateral uveitis, evanescent cranial nerve palsies, and other clinical manifestations suggesting central nervous system and ocular sarcoidosis. Random biopsy of a normal-appearing conjunctiva revealed a noncaseating granuloma consistent with sarcoidosis. Since conjunctival biopsy is a simple office procedure with minimal morbidity, this diagnostic tool should be considered for patients with clinically suspected sarcoidosis, even in the absence of conjunctival follicles or nodules.
D000328:Adult; D001706:Biopsy; D003228:Conjunctiva / Q000473:pathology*; D005128:Eye Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D012507:Sarcoidosis / Q000473:pathology*; D014605:Uveitis / Q000473:pathology