Periocular or intraocular infection mainly by Mycobacterium species is defined as “ocular tuberculosis” (ocular TB), which mainly occurs by hematogenous dissemination of the pulmonary and extrapulmonary TB. The most common clinical presentation of ocular tuberculosis is uveitis, with posterior uveitis being the most common followed by anterior uveitis, panuveitis, and intermediate uveitis.
Definitive diagnosis may be achieved by examination of smears and staining for acid-fast organisms and cultures of intraocular tissue/fluid for Mycobacterium tuberculosis.
The current treatment of intraocular TB consists of use of isoniazid, rifampicin, ethambutol, and pyrazinamide for a long period of time.
Since ocular TB is a masquerading disease with different clinical manifestations, with no gold standard test for a certain diagnosis, an empirical clinical approach, including ocular and systemic examination, laboratory testing of the bacillus in the intraocular fluids and tissues by direct microscopy, culture, or PCR, is needed to make a definitive diagnosis.
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