Sarcoidosis and Behçet disease in the eye
- Eye and systemic disease
Sarcoidosis causes granulomatous uveitis; Behçet disease causes a hypopyon uveitis and retinal vasculitis that can blind quickly.
See it in 3D: Iris · Retina · Lacrimal gland
What it is
Sarcoidosis and Behçet disease are two systemic inflammatory diseases in which the eye is often affected and sometimes the first organ involved. Sarcoidosis forms granulomas: large greasy deposits on the cornea, iris nodules, enlarged lacrimal glands and patchy inflammation of retinal veins. Behçet disease is an occlusive vasculitis with recurrent mouth and genital ulcers; its eye disease is recurrent, explosive and can destroy vision in a few attacks.
Eye findings
- Sarcoidosis: granulomatous anterior uveitis (mutton-fat deposits, iris nodules), intermediate uveitis, periphlebitis, lacrimal gland swelling.
- Sarcoidosis may need a chest CT and a biopsy of an accessible lesion (conjunctiva, skin, lymph node) to confirm it.
- Behçet disease: recurrent oral ulcers plus genital ulcers, skin lesions, positive pathergy test and eye disease.
- Behçet uveitis: hypopyon in a relatively white eye and occlusive retinal vasculitis.
Screening and follow-up
- Granulomatous uveitis also suggests tuberculosis and syphilis, which must be excluded before immunosuppression.
- Behçet retinal vasculitis needs early systemic immunosuppression and biologic drugs.
- Both diseases need joint care between ophthalmology and rheumatology or internal medicine.
Next step / Initial management
- Granulomatous uveitis: chest imaging, ACE and lysozyme, calcium, and exclusion of tuberculosis and syphilis.
- Suspected Behçet disease with eye involvement: same-day ophthalmology and early systemic treatment.
- Any recurrent uveitis with mouth ulcers: ask about genital ulcers and skin lesions.
- Corticosteroid-sparing therapy under specialist care for chronic disease.
Test yourself
Think of the answer, then tap the question to see it.
What are mutton-fat keratic precipitates?
Large, greasy inflammatory deposits on the back of the cornea, typical of granulomatous uveitis (sarcoidosis, tuberculosis, syphilis).
What is the eye disease of Behçet disease?
Recurrent uveitis, often with hypopyon, and occlusive retinal vasculitis that can cause rapid visual loss.
What must be excluded before immunosuppression for granulomatous uveitis?
Tuberculosis and syphilis.
Connections
See it in 3D3
The structures of Durgical's 3D anatomy where it is found.
Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once.
Sources: Ocular Sarcoidosis (StatPearls Publishing (NCBI Bookshelf), 2026); Behcet Disease (StatPearls Publishing (NCBI Bookshelf), 2026); Granulomatous Uveitis (StatPearls Publishing (NCBI Bookshelf), 2026).
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Representative model, for educational purposes only.