Bilateral corneal keratolysis (corneal melt) in sarcoidosis.

BACKGROUND AND AIM: Corneal involvement in sarcoidosis is rare, and central corneal keratolysis has not been previously described. We present the first reported case of bilateral central corneal keratolysis in a patient with multi-organ sarcoidosis. Results: A 37-year-old woman with pulmonary, cutaneous, and ocular sarcoidosis presented with severe bilateral ocular pain, photophobia, and rapidly progressive vision loss. Examination revealed severe uveitis with bilateral hypopyons and central corneal keratolysis. Results from infectious, rheumatological, and vasculitis work-up were negative. She was treated with high-dose intravenous corticosteroids, methotrexate, and infliximab but developed significant stromal scarring with persistent visual impairment. Conclusions: This case highlights the need to consider sarcoidosis in the differential diagnosis of rapidly progressive keratolysis, particularly in patients with known systemic disease or anterior sarcoid uveitis.