Detection of the new tuberculosis: ocular examination as a diagnostic imperative.
BACKGROUND
Until recently, tuberculosis in the U.S. had been considered a public health concern of the past, largely conquered by therapy devised in the 1950s. However, in the past several years, the incidence of tuberculosis has increased steeply and unexpectedly, owing to a conspiracy of new factors. These include: the epidemic of acquired immune deficiency, the emergence of drug-resistant strains, the confinement of susceptibles in crowded shelters, and the premature demolition of public health programs.


METHODS
A dynamic interplay exists between the tubercle bacillus and the declining immune system in AIDS patients. Because of this, many atypical, clinical presentations of tuberculosis have emerged.


RESULTS
The detection of ocular manifestations of tuberculosis has thus assumed increased importance. It can allow not only for an earlier diagnosis of TB, but an earlier diagnosis of AIDS, preventing spread of both diseases within the population.


CONCLUSIONS
Evaluation of ocular signs of tuberculosis should now be a diagnostic imperative.
Frankel
R M
RM
New England College of Optometry, Boston, MA 02115.
Boname
M E
ME
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D006801:Humans; D015994:Incidence; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology