A 28-year-old woman presents with unilateral panuveitis, posterior synechiae, and a hypopyon. Chest X-ray shows bilateral hilar lymphadenopathy. Serum ACE and lysozyme are elevated. The MOST likely diagnosis causing her uveitis is:
- A Behçet's disease
- B HLA-B27-associated uveitis
- C Ocular sarcoidosis ✓
- D Vogt-Koyanagi-Harada syndrome
Correct answer: C. Ocular sarcoidosis
Explanation
Sarcoidosis causes granulomatous uveitis (mutton-fat KPs, iris nodules — Koeppe and Busacca, snowball vitreous opacities), often panuveitis, with bilateral hilar lymphadenopathy on CXR and elevated ACE/lysozyme. HLA-B27 uveitis is acute non-granulomatous anterior uveitis with fibrinous hypopyon, often recurrent. Behçet's causes explosive hypopyon uveitis with oral/genital ulcers. VKH is bilateral panuveitis with exudative retinal detachments, choroidal thickening, and integumentary findings.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.