Multifocal choroiditis and acute posterior multifocal placoid pigment epitheliopathy occurring in the same patient.

tuberculosis, which can be manifested as both anterior and posterior uveitis or as conjunctival nodules and phlyctenules. However, the majority of ocular tuberculosis are unilateral, and cases of ocular involvement is only rarely noted in systemic tuberculosis. One study reported only 28 cases of iritis among 10535 patients with tuberculosis. The chest x-ray film and a purified protein derivative skin test in this patient showed no evidence of tuberculosis. Gout, known to deposit urate crystals in ocular tissues, can cause conjunctival nodules, band keratopathy, and rarely anterior uveitis. However, depositions in the conjunctiva, as well as in the cornea, have been described within interpalpebral areas. The location of urate deposition differs from our patient with conjunctival nodules only in the superior bulbar conjunctiva. This article describes a patient with VKH syndrome with an initial manifestation of bilateral conjunctival nodules and anterior uveitis. The diagnosis was supported by the fulfillment of the diagnostic criteria of VKH syndrome and the exclusion of other possible diseases. To the best of our knowledge, this article represents the first case of conjunctival nodules in VKH syndrome. We thereby stress the importance of clinical awareness of conjunctival nodules as the initial sign of VKH syndrome.