Abstract
Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional descriptive study was conducted in the National Tuberculosis Centre, Bhaktapur and BP Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal during a period of 18 months from February 2010 to August 2011. Diagnosed cases of systemic tuberculosis were evaluated by ophthalmologists for any ophthalmic manifestations. Results: There were 585 cases in the study. 399 (68%) were cases of pulmonary tuberculosis and 186 (32%) were that of extra pulmonary tuberculosis. Ocular manifestations were seen in 2.6% (15 patients) of the study population; 1.25% (6 patients) in cases of pulmonary tuberculosis and 5.37% (9 patients) in extra pulmonary tuberculosis cases. Uveitis (40%) followed by papilloedema (33%) were the two most common ocular manifestations. Of the 25 affected eyes of 15 patients, 2 eyes of patients with choroiditis involving the macular area were legally blind. Majority of the affected cases (67%) had bilateral involvement. Conclusion: Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented. Ocular manifestations are more common in extra pulmonary tuberculosis cases.
Highlights
Tuberculosis is an infectious disease of chronic pathology caused by one of the members of the Mycobacterium tuberculosis complex that includes M. tuberculosis, M. bovis, and M. africanum
Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented
Survey suggests that a significant number of people in productive age group suffer from Tuberculosis in Nepal [7]
Summary
Tuberculosis is an infectious disease of chronic pathology caused by one of the members of the Mycobacterium tuberculosis complex that includes M. tuberculosis, M. bovis, and M. africanum (most commonly by M. tuberculosis). This disease is characterized by formation of granulomas. The disease is spread through airborne aerosol gaining access in the lung, resulting in a latent or dormant infection in susceptible hosts. There is an estimated 9.6 million new cases and 1.5 million deaths are attributed to TB. About 58% of cases are in the South-East Asia and Western Pacific regions. In Nepal alone there are 44,000 new cases and 60,000 people living with TB, with 4900 death a year [1]
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