The Eyes in Sarcoidosis.

THE importance of ocular lesions in sarcoidosis was not recognized until recently, although they have been known for much longer (Bloch, 1914; Mylius and Schiirmann, 1929; Schaumann, 1934). Most of the early literature was preoccupied with Heerfordt's syndrome and Bruins Slot (1936) eventually identified this as a form of sarcoidosis. Osterberg (1939) made the first attempt to study how sarcoidosis affects the eyes, but he found only 27 reports of it among 500 patients in the European literature to that time. Soon afterwards, however, Levitt (1941) collected 100 patients from recent literature, of whom 43 had had their eyes affected; 28 had uveitis and ten were blind. In the following years Woods and Guyton (1944) described uveitis in fifteen of 29 patients, Gifford and Krause (1949) reported ocular lesions in ten others, and Ricker and Clark (1949) and Longcope and Freiman (1952) recorded briefly the ocular findings in their series of patients with sarcoidosis, concluding that the eyes were more often affected in the Negro. It was evident from these American accounts that ocular sarcoidosis was an important part of the disease. Within the last decade treatment with corticosteroids has been shown to cause regression of the lesions of sarcoidosis, especially those of the eyes and lungs. The advent of effective treatment drew attention to the need for further study of the eyes so that early lesions may be recognized, their significance assessed, and indications for treatment defined. Crick gave a precursory review of our patients in 1955 and Ainslie and James (1956) and James (1959) reported the ocular findings in their series of 100 and 200 patients respectively. The present paper is based on a detailed study of the eyes of 185 patients with sarcoidosis by the same group of observers using a standard examination technique.