Ocular Tuberculosis

Excerpt

Ocular tuberculosis is a clinical disease caused by Mycobacterium tuberculosis (TB). It has various modes of transmission, and it can infect virtually any ocular tissue. Much like the ability of syphilis to mimic various skin conditions, TB should be thought of as “the great imitator” of ocular pathologies.

Choroidal tubercles were first anatomically described in 1855 and identified with an ophthalmoscope in 1867. One year after the discovery of the organism, TB was identified in the eye in 1883. An autopsy study of military TB in 1950 even reported that eye examination exceeded chest radiography in diagnostic sensitivity. Since this time, TB has become increasingly rare in Western nations, and advancements in laboratory diagnostic tests have led eye examinations for choroidal tubercles to fall out of favor in recommendations and guidelines.

More than 1.7 billion people are estimated to be infected with TB. Globally, it is the leading cause of death from a single infectious agent and the leading cause of death among persons living with human immunodeficiency virus (HIV) infection. It is important to recognize ocular TB as a clinical manifestation of extrapulmonary TB. A timely diagnosis can lead to early initiation of anti-tuberculosis therapy (ATT) and prevent poor patient outcomes.