Orbital tuberculosis presenting as vision loss and headache: early management is paramount.

Publication date: Oct 14, 2024

Orbital tuberculosis is a rare form of extra pulmonary TB and may arise either by hematogenous route or spread directly from the paranasal sinus. We herein report two cases of orbital TB with a vision threatening complication. Case-1 is a 31-year-old female with a headache, a diminution of vision in the right eye, and pain in ocular movement. On examination, there was no proptosis with RAPD present in right eye and tenderness on palpation. CEMRI revealed a diffuse infiltrating lesion at the orbital apex, suggesting of inflammatory pathology. Case-2 is a 40-year-old male with similar complaints in the left eye, CECT showed edema and swelling in the optic nerve and extraocular muscle of the left eye. A detailed investigation was done, and a diagnosis of orbital tuberculosis was made in both patients. They were started on ATT and oral steroids but lost follow-up initially and due to delayed treatment, it led to irreversible vision loss. A long-term follow-up showed resolution of ocular symptoms with occasional headaches.

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Concepts Keywords
Extraocular Orbital apex syndrome
Headaches Orbital TB
Old Tuberculous
Ophthalmic
Tuberculosis

Semantics

Type Source Name
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH proptosis
disease MESH edema
drug DRUGBANK 5-amino-1 3 4-thiadiazole-2-thiol
disease MESH delayed treatment
disease MESH syndrome

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