18.2

Tuberculosis

Introduction:

Mycobacterium tuberculosis can infect many extrapulmonary organs, including the eyes. It is a common infectious cause of uveitis in certain, mostly tropical, countries. HIV-infected patients are particularly at risk to disease.

Clinical Features:

Ocular manifestations include choroidal granuloma, choroiditis, chorioretinitis, optic nerve infiltration, and uveitis (Figs 18.2.1 and 18.2.2). Choroidal involvement can cause a large plaque in the posterior pole, similar to that seen in serpiginous choroiditis, or can be multifocal in nature. Multiple old, inactive associated chorioretinal scars are suggestive of tuberculosis.

Figure 18.2.1 Color photograph of active tubercular chorioretinitis involving the macula and optic nerve. (Courtesy of Alay S. Banker, MD.)

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