Are the patients with drug sensitive tuberculosis screened for ocular manifestations? A five year analysis from a medical college hospital of Karnataka, India

Abstract

Background: Early diagnosis and prompt treatment may be sight-saving in patients with Ocular Tuberculosis (TB). Patients on anti tubercular treatment (ATT) also need ophthalmological examination at the start of the treatment and monitoring for toxic optic neuropathy regularly till the completion of treatment. This study is a situation analysis of the referral rates to ophthalmologist and clinical presentations of ocular TB among patients admitted with drug sensitive tuberculosis (DS TB).

Methods: A five year record analysis (2013-2017) of patients admitted with DS TB in a medical college hospital setting was done. Demographic and clinical presentations of the patients were recorded. The details about the referral, clinical findings, any possible risk associated with ocular TB and ocular side effects of ATT were noted. Data was entered in Microsoft excel and analysed for descriptive statistics.

Results: Among 225 inpatients, only 72 (32%) patients were referred to ophthalmologist. The referral rates increased over the period of five years. Intra ocular TB was diagnosed among 11 (15.3%) patients. Only 5 patients among these had complained of reduced vision and others were asymptomatic.

Conclusion: The referral of DS TB patients to ophthalmologist was sub optimal. All the DSTB cases need ophthalmic evaluation keeping in mind the possibility of ocular TB and also the adverse effects of ATT.

Keywords: Ethambutol; Ocular tuberculosis; Optic neuropathy; Uveitis.