Granulomatous orbital inflammation: Orbital tuberculosis (TB)

1 Signs and Symptoms

• Risk factors to acquire orbital Tb include contact with an index case, lower socio-economic status, drug abusers, and some health care workers [1].

• The condition presents in one of the five forms [2]:

  • (i) Orbital tuberculoma or cold abscess without bone involvement: Presenting features include proptosis, palpable orbital mass lesion, diplopia, and pain (Fig. 1). Lesion can either be well-defined, or diffuse, with intracranial extension.

  • (ii) Classic periostitis: Chronic ulceration or discharging sinus in the periorbital region, with skin tethering to the surrounding bone, often leading to ectropion (Fig. 1). CT scan shows bony erosion, with irregular thickening of the bone, most commonly seen to affect the orbital margin.

  • (iii) Tuberculoma with bony involvement: Proptosis with bony involvement is seen in this category, and intracranial extension may also occur (Fig. 2)

    Fig. 2

    

    An 8-year-old child with right periorbital fullness withnon axial proptosis and globe...