23 yo girl with recurrent painful scleritis which subsided only temporarily under steroid therapy. She developed a sclero-corneal inflammation and scleritis on the other eye (shown here). The Mantoux-test was strongly positive. She was treated with rifampicin and INH systemically, without any local therapy. The inflammation regressed, the patient's health improved and she gained weight. This therapeutic approach confirms the diagnosis of ocular TBC. It may be understood as a hypersensitivity reaction to tuberculous proteins from a distant location. The picture shows an active scleritis and a limboscleratitis.
Rao, Rama Mohan, Prof. Dr. med., India, Prof. Dr., Mangalore