Sarcoidosis presenting as a suspected metastasis around the optic disc

We present a case of systemic sarcoidosis presenting with mild blurred vision, limitation of left eye movements and choroidal infiltration around the left optic disc. Symptoms and signs of inflammation were absent, and secondary malignancy was suspected. After a prolonged series of investigations revealed multiple asymptomatic inflammatory lesions, subsequent lymph node biopsy revealed non-caseating granulomas. This case highlights the protean manifestations of sarcoidosis and the sophisticated investigations that may be required to diagnose it.