Goh K.Y.,Tan Tock Seng Hospital |
Fong K.S.,Gleneagles Medical Center and |
Eric H.Y.C.,Tan Tock Seng Hospital
Neuro-Ophthalmology Japan | Year: 2010
A 40-year-old Chinese female complained of bilateral blurring of vision for the past 3 months. This was associated with intermittent headaches for the past 5 years. She does not have other systemic complaints nor illnesses. Ophthalmic examination revealed her best corrected visual acuities of 6/7.5 in the right eye and 6/9 in the left eye. Her colour vision and visual fields were normal. There were old mutton fat keratic precipitates in her left eye. Fundoscopy revealed bilateral optic disc swellings. An urgent MRI of the brain showed bilateral lacrimal gland enlargement with enhancement. No intracranial masses were seen. A lumbar puncture revealed mildly raised opening pressures with lymphocytosis and raised proteins. She underwent a lacrimal gland biopsy which showed multiple non-caseating granulomas with multi-nucleated giant cells and adjacent lymphocytes, consistent with sarcoidosis. A high resolution CT thorax did not show any enlarged mediastinal lymph nodes. She was treated with oral prednisolone at 1mg/kg/day for 2 weeks followed by a 5 mg taper every 2 weeks. Her headaches and disc swellings subsided with treatment.