Fitting silicone hydrogel contact lenses with special diameters in a microcornea with micro and dislocated pupil

Purpose: Sarcoidosis is a chronic, multisystem granulomatous inflammatory disorder of unknown etiology. It is characterised by infiltration of tissues with macrophages and Th1/Th17lymphocytes, which culminates in the formation of noncaseating (nonnecrotizing) epithelioid cell granuloma in the affected organ. The author presents a case report of a patient who presented with bilateral granulomatous anterior uveitis as the presenting feature of ocular sarcoidosis. Method: A 40-year-old woman presented to the office with a chief complaint of pain, photophobia, tearing, redness, and cloudy vision in both eyes of 7 days duration. Clinical evaluation revealed bilateral granulomatous anterior uveitis with inflammatory ocular hypertension. Laboratory investigation demonstrated raised levels of serum Angiotensin-Converting Enzyme (ACE) and chest radiography revealed moderate bilateral pulmonary interstitial disease. The diagnosis was re-evaluated as presumed sarcoidosis-associated granulomatous anterior uveitis in line with the diagnostic criteria of the International Workshop on Ocular Sarcoidosis (IWOS). Result: A successful resolution of the granulomatous anterior uveitis with inflammatory ocular hypertension was achieved with topical therapy with corticosteroid, cycloplegia and ocular hypotensive agent. Theocular condition resolvedwithout any complications within 6 weeks. Conclusion: Sarcoid-associated anterior uveitis is an immunemediated sight-threatening eye condition. The inflammatory response in ocular sarcoidosis is characterised by an overexpression of proinflammatory cytokines and chemokines. Because Th1and Th17derived cytokines play a role in the pathomechanism of ocular sarcoidosis, early diagnosis and intervention with immunosuppressive therapy are vital to reducing ocular morbidity.