Hegab S M, al-Mutawa S A, Sheriff S M
Eye Department, Ibn-Sina Hospital, Kuwait.
J Pediatr Ophthalmol Strabismus. 1998 Nov-Dec;35(6):323-6. doi: 10.3928/0191-3913-19981101-07.
To review reported external ocular manifestations of sarcoidosis and to present bilateral, multilobular, nodular, limbal, corneal nodules as being a unique manifestation of the disease.
A 16-year-old Saudi girl presented with bilateral, multilobular, solid, limbal nodules, with a vascular supply from the conjunctival vessel, and associated membraneous conjunctivitis and healed trachoma. The Schirmer's test revealed less than 2 mm in both eyes with tear meniscus less than 2 mm. Biopsy of an associated palpebral conjunctival nodule was performed, in addition to a gallium scan, chest X-ray, and a serum angiotensin-converting enzyme (SACE) level.
The culture showed beta-hemolytic streptococci. Gallium scan showed intake by both lacrimal glands. Her chest X-ray results were normal, as was the SACE level. Biopsy of the excised conjunctival nodule disclosed a noncaseating granulomatous reaction with epithelioid and giant cells, and chronic inflammatory cell infiltrate confirming a diagnosis of sarcoidosis.
A multilobular, nodular, perilimbal mass as a unique manifestation of sarcoidosis is presented. A streptococcal membraneous conjunctivitis and healed trachoma superimposed. A review of sarcoidosis of the external eye is included.
回顾结节病的眼部外在表现报道，并提出双侧、多叶、结节状、角膜缘结节是该疾病的一种独特表现。
一名16岁沙特女孩，双眼出现双侧、多叶、实性角膜缘结节，由结膜血管供血，伴有膜性结膜炎及已愈沙眼。泪液分泌试验显示双眼泪液分泌均少于2mm，泪液弯月面小于2mm。除进行镓扫描、胸部X线检查及血清血管紧张素转换酶（SACE）水平检测外，还对相关睑结膜结节进行了活检。
培养显示β溶血性链球菌。镓扫描显示双侧泪腺摄取。胸部X线检查结果及SACE水平均正常。切除的结膜结节活检显示非干酪样肉芽肿反应，伴有上皮样细胞和巨细胞，以及慢性炎性细胞浸润，确诊为结节病。
提出双侧、多叶、结节状角膜缘肿物是结节病的一种独特表现。叠加有链球菌性膜性结膜炎及已愈沙眼。文中包含了对眼结节病的综述。
