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Related Experiment Video

Updated: Jan 19, 2026

Separation and Fractionation of Culture Filtrate Proteins (CFPs) from Mycobacterium tuberculosis
08:48

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Published on: July 11, 2025

554

Paradoxical reactions in ocular tuberculosis.

Sudha K Ganesh1, Sharanya Abraham2, Sridharan Sudharshan2

  • 1Medical Research Foundation, Sankara Nethralaya, 18, College Road, Chennai, 600 006, India. drskg@snmail.org.

Journal of Ophthalmic Inflammation and Infection
|September 8, 2019
PubMed
Summary

Paradoxical reactions can worsen ocular tuberculosis during treatment. Early recognition and corticosteroid use can restore vision, often without altering anti-tubercular therapy.

Keywords:
Anti-tubercular therapyCorticosteroidsHIVImmune-reconstitution inflammatory syndrome (IRIS)ImmunosuppressivesJarisch–Herxheimer reactionOcular tuberculosisParadoxical reactionParadoxical worseningSyphilis

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Immunology

Background:

  • Paradoxical reactions (PRs) are documented in extrapulmonary tuberculosis.
  • Ocular tuberculosis can also present with PRs during anti-tubercular therapy (ATT).
  • Immune system dysregulation is implicated in PR development.

Purpose of the Study:

  • To highlight the occurrence and management of PRs in ocular tuberculosis.
  • To inform clinicians about recognizing and treating these reactions.
  • To emphasize the role of corticosteroids and immunosuppressants.

Main Methods:

  • Literature review on paradoxical reactions in tuberculosis.
  • Clinical case series analysis (if applicable).
  • Discussion of immunological mechanisms.

Main Results:

  • PRs can lead to vision impairment in ocular tuberculosis patients on ATT.
  • Prompt recognition is crucial for effective management.
  • Corticosteroids and immunosuppressants can restore vision.

Conclusions:

  • Clinicians must be aware of PRs in ocular tuberculosis.
  • Timely intervention with corticosteroids and immunosuppressants is key.
  • Discontinuation or alteration of ATT may not be necessary.