Bilateral internal ophthalmoplegia in a patient with sarcoidosis.

Ocular signs are common in systemic sarcoidosis. Upwards of 50 per cent. of affected patients develop a granulomatous anterior uveitis, and fundus lesions are frequently observed. Ocular findings due to central nervous system involvement are less frequent, but can be the initial complaint. The subject of central nervous system involvement in sarcoidosis has been reviewed by Colover (I948) and Walsh and Hoyt (i 969a). In this paper, we report a patient whose initial ocular manifestation of sarcoidosis was an internal ophthalmoplegia. Her systemic illness went undiagnosed for many months until she developed a severe bilateral granulomatous uveitis and secondary glaucoma. The literature dealing with internal ophthalmoplegia in sarcoidosis is reviewed.