Case Report – Ocular Tuberculosis associated with miliary and leptomeningeal tuberculosis

Abstract

A 17 year old immunocompetent young man           developed pain, photophobia and defective vision in the Right eye. MRI chest showed features of miliary tuberculosis while MRI brain showed multiple ring enhancing lesions suggestive of leptomeningeal tuberculosis for which he was started on Anti-tubercular therapy. After an initial               misdiagnosis of Horner’s syndrome, patient presented 4 months later with visual acuity of 1/60 in the right eye and 6/6 in the left. Right eye showed keratic precipitates,            shallow anterior chamber, iris neovascularisation, posterior synechiae and complicated cataract with intraocular              pressure of 4 mm Hg. He was diagnosed withRight eye granulomatous pan-uveitis of probable tubercular origin and advised to continue anti-tubercular therapy and started on oral and topical steroids. Despite all efforts, after 1 year, vision in the right eye had worsened to hand motions,      intraocular pressure was still 5 mm Hg and subsequently it progressed to phthisis bulbi.