UNILATERAL PAPILLEDEMA IN A 12 YEAR-OLD GIRL - A SURPRISING DIAGNOSIS

A previously well 12 year old girl presented with diminished visual ac uity and haziness of her left eye. Her examination confirmed visual lo ss in her left eye and significant disc blurring on fundoscopy. Extens ive investigations including computerised tomography of the brain and orbit were normal, Her serum angiotensin converting enzyme (ACE) level s were elevated and subsequent Kveim test was positive confirming the diagnosis of ocular sarcoidosis, She did respond to a course of system ic steroids and over the following 3 years her eye signs and symptoms did correlate well with the ACE level. To date she has not had any sys temic or respiratory symptoms. Thus sarcoidosis should be considered i n the differential diagnosis of ocular pathology of unexplained aetiol ogy.