A rare case report of tuberculous uveitis

Background: Uveitis is a broad range of disease processes that involves the uveal tract and its associated ocular structures. Tuberculosis was leading causes of uveitis in the past but the incidence has reduced with the improved antibiotic therapy. Recently, incidence of ocular involvement due to tuberculosis has again been raising. Tuberculous uveitis can be readily treatable and if not diagnosed early can be vision threatening with irreversible blindness for the patient. In this study we are reporting a rare case of refractory uveitis, responding to anti-tuberculous therapy inspite of being no positive investigations in favour of tuberculosis. Case presentation: A 48 years immunocompetent male had reported to ophthalmology opd with diminision of vision in both eyes since 2 months which was of painless and progressive type. Patient is a known diabetic since 2 years and is on regular treatment. Patient was initially diagnosed as TORCH related uveitis and treated for the same. There was initial response to treatment, following which patient developed relapse within 1 month duration. Later, Tuberculosis being one of the most common causative agents of uveitis, patient has been emperically started on ATT, following which there is resolution of lesions. Conclusion: It is essential to know the varied range of ocular manifestations of tuberculosis as there is no specific test to confirm the diagnosis. Early recognition and timely management prevents the severe blinding complications in these patients.

Case Study

In the developing countries, incidence of systemic tuberculosis is very high, with over 8 million new cases each year. The incidence of tuberculous uveitis is also rising correspondingly. It is difficult to diagnose ocular tuberculosis because of the lack of specific ocular findings and specific confirmatory laboratory tests. However, in a developing country like India, where the prevalence of latent tuberculosis is high, uveitis of unexplained cause not fitting into known uveitis entities, in presence of Monteux positivity, is more likely to be tubercular in origin. Hence, early diagnosis and prompt treatment with antitubercular treatment may result in dramatic drop in recurrence and improve individual patient outcomes.