A Case Ocular Tubereulosis Associated with Seleral Perftration

ABSTRACT

Tuberculosis, once thought to be the most common cause of uveal is now thought to be a relatively rare cause of ocular disease. This is because of a decreased incidence of tuberculosis as well as a lessened emphasis on its diagnosis. Tuberculosis of uveal tract has long been a controversial subject in ophthalmology. Several factors have been implicated including the marked pleomorphism of the lesions, owing to variations in the virulence of the invading organisms, host resistance, and the presence or absence of host immunity. Solitary choroidal tuberculoma is rare and characterized as gradually growing until it resembles a tumor projecting as a round white or yellowish globular mass into the cavity of the eye. It may progress continuously and so finally, in the absence of treatment, the sclera is involved and perforation results which is followed by phthisis bulbi or pyogenic infection and panophthalmitis. We have experienced a 19-year old female who had a solitary choroidal tumor like lesion, which about 17 months later resulted in scleral perforation, in the posterior pole of the left eye. We performed enucleation of the left eyeball under the clinical diagnosis of the maligant melanoma associated with scleral perforation and obtained the histopathological diagnosis of ocular tuberculosis.