Neuro-Ophthalmological Findings as First Manifestation of Occipital Tuberculoma

We present a 54-year-old male garbage collector, who came to the ophthalmology department due to one-month history of bilateral blurred vision, palinopsia, headache and visual geometrical hallucinations. The examination showed a normal anterior segment, a homonymous left upper central scotoma and tilted segmental hypoplasia of the optic nerve of the left eye. Contrast-enhanced brain magnetic resonance imaging showed a mass lesion in the right occipital cortex. At biopsy, tuberculosis was found. Subsequently, anti-tuberculous treatment led to a good response with resolution of the palinopsia and visual hallucinations, and improved vision.