Abstract
Scleritis is a severe painful inflammatory process involving the outer coat (sclera) of the eye, resulting in disabling ocular pain and a wide range of symptoms. Causes of scleritis are broadly idiopathic, autoimmune, and infectious and masquerade syndrome.
Tubercular scleritis is a rare and unique form of extrapulmonary tuberculosis. The causative organism is the Mycobacterium tuberculosis. Tuberculous scleritis may result from either a direct invasion of the sclera by the bacterium or an immune reaction to circulating antigens.
Usual scleritis management with nonsteroidal anti-inflammatory drugs (NSAIDs) should still be commenced, if there are no contraindications. Antituberculosis therapy (ATT) should be initiated upon diagnosis of tubercular scleritis and should be comanaged with a physician. Treatment should be tailored to the patient and monitored clinically for resolution or recurrence.
Complications of sclerokeratitis, concomitant uveitis, glaucoma, cataract, and exudative retinal detachment (in the event of posterior scleritis) should be monitored closely for.
The diagnosis and management of tubercular scleritis can be challenging. Tuberculosis must be considered as one of the differentials in the evaluation of a patient presenting with scleritis, especially in setting of a TB-endemic region.
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Helen, M.F., Agrawal, R., Gupta, V., Pavesio, C. (2017). Tubercular Scleritis. In: Kumar, A., Chawla, R., Sharma, N. (eds) Ocular Tuberculosis. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-57520-9_13
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DOI: https://doi.org/10.1007/978-3-319-57520-9_13
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