Hello everyone !
This is a short post about the manifestations of Tuberculosis in the eye.
TB is associated with a lot of findings in the eye.
We can classify them as :
1. Disease related.
2. Therapy related.
Let's look at the first one.
1. Disease related :
A. Extra Ocular structures -
I. Appendages :
Eyelid - Lupus Vulgaris. Lid granuloma.
Lacrimal apparatus - TB Dacryoadenitis. Dacryocystitis.
II. Orbit :
B. Ocular manifestations -
I. Conjunctiva -
Phlyctenular Conjunctivitis - due to hypersensitivity to Tuberculin. Seen as intense itching , discharge , redness and nodules.
II. Cornea -
III. Uvea -
Granulomatous uveitis ( Chronic anterior Uveitis ). Shows Mutton Fat appearance.
Choroiditis - Choroid Tubercles - classic of TB Uveitis. Tuberculoma may be seen. Miliary choroid nodules may be seen.
IV. Retina -
Eale's disease - may be a result of Hypersensitivity to Tuberculin. Although causality is not established clearly.
Sub retinal Tubercles.
2. Therapy Related :
A. Ethambutol - may cause Optic Neuritis - generally retrobulbar type. With Color Blindness.
B. INH - Isoniazid can cause retrobulbar optic neuritis, although this is much rarer.
C. Immune Reconstitution Inflammatory Syndrome - When a person recuperates from TB /HIV his immune system may become hyperactive and show Immunologically mediated uveitis.
Hope this helps !