A delay or lack of diagnosis may lead to severe visual morbidity.

The incidence of tuberculous uveitis at the Wilmer Eye Institute (Baltimore, Md) fell from 79% in 1944 to 22% in 1953.37 The incidence of uveitis caused by tuberculosis at the Massachusetts Eye and Ear Infirmary (Boston) from 1982 through 1992 was only 0.6%.13 Uveitis is more likely to be attributed to tuberculosis in parts of the world where the prevalence of tuberculosis is higher. Fernandes There may be a false-negative result in patients with AIDS or in cases of drug-resistant disease.  RGupta  RW Acute tuberculosis panophthalmitis. Muccioli If the vision does not improve after 10 to 15 weeks of drug discontinuation, treatment with parenteral hydroxocobalamin, 40 mg/d during a 10- to 28-week period, should be considered. Intraocular tuberculosis, a challenge in diagnosis and treatment.  PJayanthi  RSWright It may be more anterior than syphilitic interstitial keratitis and have more frequent recurrences.16 As is the case with phlyctenular keratoconjunctivitis, mycobacterial proteins are postulated as antigens that induce a corneal hypersensitivity reaction.26 Treatment of tuberculous interstitial keratitis consists of systemic as well as topical antituberculous chemotherapy and cycloplegia. The clinical course tends to be insidious and chronic, primarily affecting the lungs, but may also affect extrapulmonary organs, including the eye. Choroidal tubercles are usually multiple and are probably the most common form of ocular tuberculosis.42 Other manifestations of tuberculous infection of the choroid include multifocal choroiditis43 and serpiginouslike choroiditis.44, Tuberculous choroiditis has been reported in patients with AIDS and systemic tuberculosis.45,46 Choroidal tubercles in 3 patients with AIDS in a hospital in Madrid, Spain, were discovered after the initiation of systemic antituberculous chemotherapy, when the patients were considered to be in a healing stage.45 The condition of one patient with AIDS who had central nervous system tuberculosis and tuberculosis choroiditis improved dramatically after the initiation of a triple antituberculous therapy. Tuberculosis of the orbit is rare, with only 5 cases reported in the Western literature in the past 50 years. Polymerase chain reaction for the detection of. In a study reported in 1993 of autopsy eyes from 235 patients with AIDS, intraocular tuberculosis was found in only 2 eyes.15 The effect of HIV on the immune system can influence both the diagnosis, by reducing the response to PPD testing, and the success of treatment. Detection of mycobacteria using the polymerase chain reaction.  P Scleral tuberculosis.  BGray  DE  SMMahmoud

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