| Presentation preference | Oral presentation |
| Title | Do not forget tuberculosis in orbital lesions |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To report a case of orbital tuberculosis (OTB) and to review the literature |
| Methods | A 66-year-old female from an ethnic minority group presented to the Accident and Emergency department with gradual loss of vision and retrobulbar pain in the right eye. Her previous medical history included diabetes type II and hypertension. On examination best corrected visual acuity was hand movement in the right eye and 10/10 in the left. There was a right fixed pupil with positive reverse relative afferent pupillary defect but also limitation of movement of the right eye. Anterior segment examination was within normal limits. Dilated examination showed optic disc oedema in the right and normal findings in the left eye. |
| Results | Computed Tomography (CT) scan of the orbits showed a fusiform lesion measuring 9mm in the upper part of the muscle cone in close contact with the superior rectus pressing on the optic nerve. Laboratory testing was within normal limits except quantiferon which was positive. The patient was started on triple anti- TB chemotherapy. Repeated CT scan of the orbits showed complete resolution of the lesion in the right orbit after four months of treatment. Visual acuity remained stable and optic disc appeared pale on the last visit. |
| Conclusion | OTB is a very uncommon form of extrapulmonary TB. It can be classified into five types: a) classical periostitis b) soft tissue tuberculoma or cold abscess c) OTB with bony involvement d) orbital spread from the paranasal sinuses and e) dacryoadenitis. Treatment is the same as for pulmonary TB i.e. anti TB chemotherapy for six to nine months and occasionally surgery. This case illustrates the importance of considering OTB in orbital inflammatory lesions especially in high-risk groups for TB. |
| Conflict of interest | No |
1
| Last name | LIOLIOS |
| Initials of first name(s) | V |
| Department | Ophthalmology Department, Konstantopouleio General Hospital |
| City | Athens |
| Country | Greece |
2
| Last name | Syriga |
| Initials of first name(s) | M |
| Department | Ophthalmology Department, Konstantopouleio General Hospital |
| City | Athena |
| Country | Greece |
3
| Last name | Kamvasi |
| Initials of first name(s) | S |
| Department | Ophthalmology Department, Konstantopouleio General Hospital |
| City | Athens |
| Country | Greece |
4
| Last name | Dalianis |
| Initials of first name(s) | G |
| Department | Ophthalmology Department, Konstantopouleio General Hospital |
| City | Athens |
| Country | Greece |
5
| Last name | Terzidou |
| Initials of first name(s) | C |
| Department | Ophthalmology Department, Konstantopouleio General Hospital |
| City | Athens |
| Country | Greece |
