Sarcoidosis is an autoimmune inflammatory disorder that can affect multiple body systems and is often associated with the eyes. In fact, nearly 60 % of patients with sarcoidosis will have ocular disease. Understanding the signs of ocular sarcoidosis is critical to preventing irreversible vision loss. This article will help identify the most important symptoms of ocular sarcoidosis.
Ocular Sarcoidosis Explained
Ocular sarcoidosis occurs when inflammatory cells accumulate in the eye, but it can also involve the lids, conjunctiva, or other external structures. These accumulations are called “granulomas,” and the disease process can damage specific ocular structures.
Ocular sarcoidosis can affect one or both eyes and may present suddenly or gradually. If left untreated, ocular sarcoidosis can cause irreversible visual loss.
Symptoms of Ocular Sarcoidosis
1. Blurry or Cloudy Vision
One of the most common complaints of patients with ocular sarcoidosis is blurry or cloudy vision, often described as “hazy” or “out of focus,” due to inflammation of the ocular inner structures.
Patients often experience difficulty reading or performing any tasks that require visual recognition, such as recognizing faces. Initially, the blurry/clear vision may only go in and out of focus, but will progressively worsen with time if untreated, until it becomes constant or lasts for longer durations.
2. Redness of Eyes or Irritation
Red, irritated, watery eyes may be the most common and classic sign of ocular sarcoidosis, whether mild or severe. Red, irritated, watery eyes are often found with other symptoms.
The white part of the eye may turn pink or become bloodshot due to inflammation of the blood vessels, and it may worsen as the day progresses.
3. Floaters
Floaters appear as either dark spots or strings that float across your field of vision. Floaters are cells that have become inflamed or debris that is floating in the eye. You may notice them better with bright backgrounds. Floaters can be annoying and distracting, and seeing many more suddenly means a medical eval is needed.
4. Photophobia (Light Sensitivity)
Photophobia is a common symptom. Bright light can be painful or discomforting to the eye (i.e., it can cause discomfort). A lamp or standard room lighting may also be too harsh for your eyes. You will find yourself squinting at entirely different terms where you may require sunglasses indoors as well. Light sensitivity also means inflammation in the front part of your eye.
5. Eye Pain
Eye pain can range from mild to severe. Some individuals experience a dull throb while others describe sharp, stabbing pain. Eye pain can worsen during eye movement or in bright light. Eye pain can result from active inflammation that requires treatment.
6. Dry Eyes
Dry or gritty eyes are common in sarcoidosis. Your eyes may feel scratchy or like you have sand in them. Eye inflammation can also lead to decreased tear production.
Dry eyes can cause overall irritation and discomfort; your eyes may water heavily due to a reflexive response. Advances in retinal health have changed the way we treat various eye diseases, including dryness caused by inflammation.
7. Seeing Halos
Halos are rings of light that surround light sources and can be more pronounced at night. This particular symptom indicates involvement with the cornea or lens of the eye.
Night driving may become difficult; halos can also affect your depth perception. Halos also indicate inflammation affecting the passage of light into your eye.
8. Vision Loss
Vision loss may be gradual or sudden. Some people will lose their peripheral vision first. Others will have problems with their central vision. Additionally, you may lose color perception; colors may appear faded or washed out. Prompt evaluation is necessary to prevent permanent damage, just as understanding the signs of macular degeneration and available treatments can help preserve vision.
9. See Lumps on the Eyelid
Some people will develop small lumps on their eyelids. These are considered granulomas that form near the surface of the eye. They may be yellow or flesh-colored.
The masses can be tender to the touch; they may also cause the eyelid to sag slightly. Granulomas should be evaluated promptly due to visible changes in the surrounding area.
10. Excessive Tearing
Your eyes may become continuously watery. This is a response to irritation, and the tear glands may be inflamed.
You may notice tears running down your face regularly. This can cause temporary blurry vision. Excessive tearing is usually associated with other symptoms, such as redness of the eyes.
When Should You See A Doctor?
If you experience any of these ocular sarcoidosis symptoms, you should seek medical help. The detection of any condition early leads to a much better treatment plan. Don’t wait until the symptoms get worse.
An eye doctor can perform tests that require an eye examination. These tests are used to check for inflammation and granulomas. It may even require blood tests or imaging.
Risk Factors to Consider
Certain risk factors place you at greater risk for ocular sarcoidosis. For example, people of African American and Northern European descent are at a higher risk. Women have been shown to develop ocular sarcoidosis slightly more than men.
The condition is typically found in individuals aged 20 to 40, but can occur at any age. If you already have sarcoidosis in another organ, it can increase your risk of getting the condition in your eyes.
Diagnosis and Testing
Diagnosing ocular sarcoidosis requires a comprehensive examination. The eye doctor will examine your visual acuity and check your eyes with specialist instruments.
Testing may involve using optical coherence tomography (OCT) to look at fine details of the eye. Fluorescein angiography can expose how inflammation looks. Some cases will require additional tests, such as imaging, and/or a chest x-ray or CT scan.
Treatment Availability
Treatment centers on treating inflammation in the eye, and corticosteroid eye drops are often prescribed. For more severe cases, oral medication may also be required.
Immunosuppressive drugs can be used to suppress the immune response. Biologics may also be used in cases of resistance. You will also have regular follow-up appointments to assess the effectiveness of treatment.
Protecting Your Vision
The best treatment is early detection; therefore, schedule regular eye examinations, be vigilant about changes in your eye health, and notify your doctor at the first sign of any change.
Be sure to attend all scheduled eye appointments; adhere to your treatment plan; and never stop any medication without first consulting your doctor.
Don’t Wait – Protect Your Vision Today
Ocular sarcoidosis can cause vision loss if left untreated. Do you remember the signs? Those signs and symptoms are your early warning system—when your vision is not 20-20: blurry vision, eye pain, floaters, light sensitivity—warrant urgent care.
Most importantly, vision loss is irreplaceable, and for every day you wait, you risk a permanent loss of vision. And the good news is that most people can keep their vision with proper care and treatment.
The specialists at Retina Vitreous Associates of Florida (RVAF) appreciate the urgency of eye conditions like sarcoidosis. Our experienced team utilizes state-of-the-art diagnostic equipment to detect inflammation at an early stage. We work closely with each patient to develop a combination of medications that protects their sight.
If you are suffering from ocular sarcoidosis, don’t wait to schedule a complete eye examination at rvaf.com. Our board-certified retina specialists are here to help.
Early intervention can change the course of ocular sarcoidosis in your favor. The sooner the evaluation takes place, the greater the chance of preserving the clarity of your vision. Your eyes have been trying to tell you something—it’s time to listen.
Please call RVAF now or go to our website to schedule your appointment. The decisions you make today will affect your future vision.