Ocular Tuberculosis Without a Lung Primary

Tuberculosis (TB) is a multisystem infectious disease caused by Mycobacterium tuberculosis, which primarily affects the lungs. It is the leading infectious cause of morbidity and mortality worldwide with significant prevalence in the developing countries. However, extrapulmonary manifestations can be seldom seen in a few patients with disseminated TB or with localized disease. These manifestations depend on various comorbidities and the immune status of the patients. Extrapulmonary tuberculosis (EPTB) constitutes multiple cases of TB in the immunocompetent and immunocompromised populace. The clinical presentation of EPTB is atypical and can be challenging to confirm, often leading to delayed diagnosis and treatment. This, in particular, is true with ocular TB. The incidence of ocular TB is uncertain due to difficulties in ocular sampling for microbiology and the lack of definitive diagnostic criteria. Ocular TB can present in a fashion similar to other conditions causing ocular inflammation. It is crucial for physicians to consider this diagnosis in their differential, as ocular TB can present in a fashion similar to that of more common conditions causing ocular inflammation. We present a rare case of ocular uveitis secondary to TB in an asymptomatic patient without a lung primary, complicated by an unmasked allergy to first-line anti-TB medication.