Walsh & Hoyt: Optic Neuritis in Sarcoidosis

Granulomatous inflammation of the optic nerve may occur in sarcoidosis, producing a typical anterior or retrobulbar optic neuritis. In some cases, the optic neuritis occurs during the disease; in others, it is the presenting manifestation. Clinical findings may be indistinguishable from those of demyelinating optic neuritis. However, the optic disc may have a characteristic lumpy, white appearance, which suggests a granulomatous etiology, andthere may be an inflammatory reaction in the vitreous. Pain, common in a demyelinating optic neuritis, is often absent in the optic europathy of sarcoidosis.