Ocular Tuberculosis with Progressive Unilateral Corneal Melting

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Ocular tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection.
• Corneal involvement in ocular tuberculosis can present with diverse and atypical clinical features.
• Differential diagnosis of chronic corneal diseases is essential for timely management.

Observation:

• A 47-year-old female presented with progressive unilateral corneal melting and subconjunctival nodules.
• Initial biopsy for tuberculosis bacillus was negative.
• Polymerase chain reaction (PCR) on biopsy sample detected Mycobacterium tuberculosis DNA.

Findings:

• Polymerase chain reaction confirmed ocular tuberculosis as the cause of corneal melting.
• The case highlights the diagnostic utility of PCR in suspected but unconfirmed tuberculosis.
• Atypical presentations of ocular tuberculosis require a high index of suspicion.

Implications:

• Ocular tuberculosis should be considered in the differential diagnosis of chronic or atypical corneal pathologies, especially in tuberculosis-endemic areas.
• Advanced diagnostic techniques like PCR can aid in diagnosing challenging cases of ocular tuberculosis.
• Prompt diagnosis and treatment are vital to prevent vision loss from corneal destruction.