Description
The incidence of tuberculosis (TB) in England and Wales increased by 21% between 1988 and 1998. Ocular disease is generally caused by haematogenous infection of ocular tissues, with the choroid being the most common site for involvement. However, immune mediated hypersensitivity reactions to inactive
tuberculous protein also occur e.g.phlyctenulosis, periphlebitis. Treatment almost always consists of systemic anti-tuberculous therapy but hypersensitivity reactions may also require corticosteroids. Diagnosing tuberculosis as the cause of ocular disease is difficult and is often presumptive. New techniques e.g.PCR may be of great benefit as tissue biopsy is difficult and active disease may not occur elsewhere. Tuberculin skin testing must be interpreted in context. Ocular complications of therapy are rare but must be considered. Improved awareness of all aspects of tuberculosis is of great importance as it is a highly communicable and very treatable disease.
