Dr.Amit Sethi

Dr.Vani Puri

Abstract

Sarcoidosis is a multisystem granulomatous disease of unknown etiology commonly affecting young adults. Prevalence of eye lid involvement is 3% in chronic sarcoid. We report a case of 53 year old lady who presented with an isolated eye lid mass with no systemic features. Ocular examination revealed BCVA of 6/6. Slit lamp and fundus examination was normal. Excision biopsy specimen on histopathology revealed a non-caseating granuloma. Stains for acid fast bacilli, Polymerase chain reaction and culture were negative. Serum angiotensin converting enzyme was positive. Chest imaging revealed perihilar lymph nodes. Mantoux test was non-reactive. On the basis of these findings, a diagnosis of sarcoidosis was made. The lesion was injected with triamcinolone which produced a reduction in size. The take home message is that the prevalence of isolated sarcoid eye lid lesion is rare and intralesional corticosteroid injection appears to be the only useful treatment.