title: Tuberculous scleral abscess with choroidal detachment.
abstract: We present a case of ocular tuberculosis (TB) presenting as scleral abscess with choroidal detachment. A 60-year-old woman presented with intense pain, redness, watering and decreased vision in the right eye (RE) for 1 week duration. Slit lamp examination of RE revealed diffuse scleritis with two pus-pointing areas in the supero-temporal quadrant suggesting scleral abscess. Fundus examination of the RE showed choroidal detachment in the temporal and inferior quadrant. Left eye examination was unremarkable. Ziehl-Neelsen staining of scleral biopsy showed acid-fast bacilli. PCR of the scleral tissue was also positive for Mycobacterium tuberculosis genome. The final diagnosis of tuberculous scleral abscess with choroidal detachment was made and patient showed good response to antitubercular treatment. In countries endemic for TB, it should be considered as a differential diagnosis for scleral abscess, since prompt diagnosis and treatment will ensure good visual outcome as depicted in our case.
authors.affiliation: Department of Ophthalmology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, India.
authors.forename: Swapnil Madhukar
authors.identifier: http://orcid.org/0000-0002-3048-7951
authors.initials: SM
authors.lastname: Parchand
authors.affiliation: Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India.
authors.forename: Aswanthi Sadesh
authors.initials: AS
authors.lastname: Kumar
authors.affiliation: Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India.
authors.forename: Subashini
authors.initials: S
authors.lastname: Kaliaperumal
authors.affiliation: Department of Ophthalmology, JIPMER, Pondicherry, Pondicherry, India.
authors.forename: Renuka
authors.initials: R
authors.lastname: Srinivasan
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D000359:Aftercare; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015862:Choroid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D009169:Mycobacterium tuberculosis; D015423:Scleritis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents