Skip to main content

Ocular Tuberculosis

  • Chapter
  • First Online:
Tuberculosis

Part of the book series: Integrated Science ((IS,volume 11))

  • 646 Accesses

Summary

Tuberculosis (TB) is a major infectious disease that primarily affects the lungs. Extrapulmonary organs, including the eyes, might be involved. Ocular TB represents an extrapulmonary spread of TB. The clinical spectrum of ocular TB is variable. It may affect the ocular adnexa with or without intraocular involvement. A high index of suspicion is needed to establish the diagnosis of ocular TB. The definitive diagnosis of TB of the eye can be established through isolation of the Mycobacterium tuberculosis bacilli in ocular tissue samples by microscopic examination or culture on specific media. Recently, evidence and experience-based guidelines for treating tubercular uveitis were proposed. This chapter reviews the ocular manifestations of TB and the recent guidelines for managing TB uveitis established by The Collaborative Ocular Tuberculosis Study group.

Graphical Abstract

Ocular tuberculosis

The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted.

Mother Teresa

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gupta V, Shoughy SS, Mahajan S et al (2015) Clinics of ocular tuberculosis. Ocul Immunol Inflamm 23(1):14–24

    Google Scholar 

  2. Dheda K, Barry CE, Maartens G (2016) Tuberculosis. Lancet 387:1211–1226

    Google Scholar 

  3. Agrawal R, Gunasekeran DV, Grant R et al (2017) Clinical features and outcomes of patients with tubercular uveitis treated with antitubercular therapy in the collaborative ocular tuberculosis study (COTS)–1. JAMA Ophthalmol 135(12):1318–1327

    Article  PubMed  PubMed Central  Google Scholar 

  4. Albert DM, Raven ML (2016) Ocular tuberculosis. Microbiol Spectr 4(6):10.1128

    Google Scholar 

  5. Dalvin LA, Smith WM (2015) Orbital and external ocular manifestations of Mycobacterium tuberculosis: a review of the literature. J Clin Tuberc Other Mycobact Dis 4:50–57

    Article  PubMed  PubMed Central  Google Scholar 

  6. Salam T, Uddin JM, Collin JR, Verity DH, Beaconsfield M, Rose GE (2015) Periocular tuberculous disease: experience from a UK eye hospital. Br J Ophthalmol 99(5):582–585

    Article  PubMed  Google Scholar 

  7. Sharma A, Thapa B, Lavaju P (2011) Ocular tuberculosis: an update. Nepal J Ophthalmol 3(1):52–67

    Article  CAS  PubMed  Google Scholar 

  8. Tabbara KF (2005) Ocular tuberculosis: anterior segment. Int Ophthalmol Clin 45(2):57–69

    Article  PubMed  Google Scholar 

  9. Sheu SJ, Shyu JS, Chen LM, Chen YY, Chirn SC, Wang JS (2001) Ocular manifestations of tuberculosis. Ophthalmology 108(9):1580–1585

    Article  CAS  PubMed  Google Scholar 

  10. Aclimandos WA, Kerr-Muir M (1992) Tuberculous keratoconjunctivitis. Br J Ophthalmol 76(3):175–176

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Arora R, Mehta S, Gupta D, Goyal J (2010) Bilateral disciform keratitis as the presenting feature of extrapulmonary tuberculosis. Br J Ophthalmol 94(6):809–810

    Article  PubMed  Google Scholar 

  12. Shoughy SS, Jaroudi MO, Tabbara KF (2016) Clinical manifestations and outcome of tuberculous sclerokeratitis. Br J Ophthalmol 100(9):1301–1303

    Article  PubMed  Google Scholar 

  13. Gupta A, Gupta V, Pandav SS, Gupta A (2003) Posterior scleritis associated with systemic tuberculosis. Indian J Ophthalmol 51(4):347–349

    PubMed  Google Scholar 

  14. Bloomfield SE, Mondino B, Gray GF (1976) Scleral tuberculosis. Arch Ophthalmol 94(6):954–956

    Article  CAS  PubMed  Google Scholar 

  15. Velasco e Cruz AA, Chahud F, Feldman R, Akaishi PM (2011) Posterior scleral tuberculoma: case report. Arq Bras Oftalmol 74(1):53–54

    Google Scholar 

  16. Bathula BP, Pappu S, Epari SR, Palaparti JB, Jose J, Ponnamalla PK (2012) Tubercular nodular episcleritis. Indian J Chest Dis Allied Sci 54(2):135–136

    Article  PubMed  Google Scholar 

  17. Bouza E, Merino P, Muñoz P, Sanchez-Carrillo C, Yáñez J, Cortés C (1997) Ocular tuberculosis. A prospective study in a general hospital. Medicine (Baltimore) 76:53–61

    Google Scholar 

  18. Biswas J, Badrinath SS (1995) Ocular morbidity in patients with active systemic tuberculosis. Int Ophthalmol 19:293–298

    Article  PubMed  Google Scholar 

  19. Shah JS, Shetty N, Shah SK, Shah NK (2016) Tubercular uveitis with ocular manifestation as the first presentation of tuberculosis: a case series. J Clin Diagn Res10:NR01–NR03

    Google Scholar 

  20. Agrawal R, Agarwal A, Jabs DA et al (2019) Standardization of nomenclature for ocular tuberculosis—results of collaborative ocular tuberculosis study (COTS) workshop. Ocul Immunol Inflamm 1–11. Published online ahead of print, 10 Dec 2019

    Google Scholar 

  21. Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature (SUN) working group. Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140(3):509–516

    Google Scholar 

  22. Gupta A, Bansal R, Gupta V et al (2010) Ocular signs predictive of tubercular uveitis. Am J Ophthalmol 4:562–570

    Article  Google Scholar 

  23. Ness T, Virchow JC (2001) Posteriore uveitis: sarkoidose oder tuberkulose [posterior uveitis: sarcoidosis or tuberculosis]. Ophthalmologe 98(2):207–211

    Article  CAS  PubMed  Google Scholar 

  24. Gupta V, Gupta A, Rao NA (2007) Intraocular tuberculosis—an update. Surv Ophthalmol 52:561–587

    Article  PubMed  Google Scholar 

  25. Babu K, Bhat SS (2014) Unilateral snow banking in tuberculosisrelated intermediate uveitis. J Ophthalmic Inflamm Infect 10:4

    Article  Google Scholar 

  26. Islam SM, Tabbara KF (2002) Causes of uveitis at the eye center in Saudi Arabia: a retrospective review. Ophthalmic Epidemiol 9(4):239–249

    Article  PubMed  Google Scholar 

  27. Gupta A, Gupta V, Arora S et al (2001) PCR-positive tubercular retinal vasculitis: clinical characteristics and management. Retina 21:435–444

    Article  CAS  PubMed  Google Scholar 

  28. Davis EJ, Rathinam SR, Okada AA et al (2012) Clinical spectrum of tuberculous optic neuropathy. J Ophthalmic Inflamm Infect 2:183–189

    Article  PubMed  PubMed Central  Google Scholar 

  29. Raina UK, Tuli D, Arora R et al (2000) Tubercular endophthalmitis simulating retinoblastoma. Am J Ophthalmol 130:843–845

    Article  CAS  PubMed  Google Scholar 

  30. Dvorak-Theobald G (1958) Acute tuberculous endophthalmitis; report of a case. Am J Ophthalmol 45:403–407

    Article  CAS  PubMed  Google Scholar 

  31. Mehta SA, Vaidya AR (2011) Post cataract endophthalmitis due to Mycobacterium tuberculosis. Ocul Immunol Inflamm 19:232–233

    Article  PubMed  Google Scholar 

  32. Ang M, Chee SP (2017) Controversies in ocular tuberculosis. Br J Ophthalmol 101(1):6–9

    Article  PubMed  Google Scholar 

  33. Agarwal A, Agrawal R, Gunasekaran DV, Raje D, Gupta B, Aggarwal K, Murthy SL, Westcott M, Chee SP, McCluskey P, Ling HS, Teoh S, Cimino L, Biswas J, Narain S, Agarwal M, Mahendradas P, Khairallah M, Jones N, Tugal-Tutkun I, Babu K, Basu S, Carreño E, Lee R, Al-Dhibi H, Bodaghi B, Invernizzi A, Goldstein DA, Herbort CP, Barisani-Asenbauer T, González-López JJ, Androudi S, Bansal R, Moharana B, Mahajan S, Esposti S, Tasiopoulou A, Nadarajah S, Agarwal M, Abraham S, Vala R, Singh R, Sharma A, Sharma K, Zierhut M, Kon OM, Cunningham E, Nguyen QD, Pavesio C, Gupta V (2019) The collaborative ocular tuberculosis study (COTS)-1 report 3: polymerase chain reaction in the diagnosis and management of tubercular uveitis: global trends. Ocul Immunol Inflamm 27(3):465–473

    Article  CAS  PubMed  Google Scholar 

  34. Tabbara KF (2007) Tuberculosis. Curr Opin Ophthalmol 18(6):493–501

    Article  PubMed  Google Scholar 

  35. Agrawal R, Testi I, Bodaghi B, Barisani-Asenbauer T, McCluskey P, Agarwal A, Kempen JH, Gupta A, Smith JR, de Smet MD, Yuen YS, Mahajan S, Kon OM, Nguyen QD, Pavesio C, Gupta V, Collaborative Ocular Tuberculosis Study Consensus Group (2020) Collaborative ocular tuberculosis study consensus guidelines on the management of tubercular uveitis-report 2: guidelines for initiating antitubercular therapy in anterior uveitis, intermediate uveitis, panuveitis, and retinal vasculitis. Ophthalmology 27:S0161–6420(20)30598-4

    Google Scholar 

  36. Agrawal R, Testi I, Mahajan S, Yuen YS, Agarwal A, Kon OM, Barisani-Asenbauer T, Kempen JH, Gupta A, Jabs DA, Smith JR, Nguyen QD, Pavesio C, Gupta V, Collaborative Ocular Tuberculosis Study Consensus Group (2020) Collaborative ocular tuberculosis study consensus guidelines on the management of tubercular uveitis-report 1: guidelines for initiating antitubercular therapy in tubercular choroiditis. Ophthalmology11:S0161–6420(20)30013-0

    Google Scholar 

  37. Agrawal R, Gunasekeran DV, Grant R et al (2017) Clinical features and outcomes of patients with tubercular uveitis treated with antitubercular therapy in the collaborative ocular tuberculosis study (COTS)-1. JAMA Ophthalmol 135(12):1318–1327

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hamade IH, Tabbara KF (2010) Complications of presumed ocular tuberculosis. Acta Ophthalmol 88(8):905–909

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Samir S. Shoughy .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Shoughy, S.S., Tabbara, K.F. (2023). Ocular Tuberculosis. In: Rezaei, N. (eds) Tuberculosis. Integrated Science, vol 11. Springer, Cham. https://doi.org/10.1007/978-3-031-15955-8_36

Download citation

Publish with us

Policies and ethics