Orbital tuberculosis presenting as vision loss and headache: early management is paramount.

Sandeep Pal, Narendra Patidar, Gunjan Tomar, Himanshu Gaikwad
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Abstract

Orbital tuberculosis is a rare form of extra pulmonary TB and may arise either by hematogenous route or spread directly from the paranasal sinus. We herein report two cases of orbital TB with a vision threatening complication. Case-1 is a 31-year-old female with a headache, a diminution of vision in the right eye, and pain in ocular movement. On examination, there was no proptosis with RAPD present in right eye and tenderness on palpation. CEMRI revealed a diffuse infiltrating lesion at the orbital apex, suggesting of inflammatory pathology. Case-2 is a 40-year-old male with similar complaints in the left eye, CECT showed edema and swelling in the optic nerve and extraocular muscle of the left eye. A detailed investigation was done, and a diagnosis of orbital tuberculosis was made in both patients. They were started on ATT and oral steroids but lost follow-up initially and due to delayed treatment, it led to irreversible vision loss. A long-term follow-up showed resolution of ocular symptoms with occasional headaches.

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眼眶结核表现为视力下降和头痛:早期治疗至关重要。
眼眶结核是一种罕见的肺外结核,可通过血源性途径或直接从副鼻窦扩散。我们在此报告两例眼眶结核并发危及视力的并发症。病例 1 是一名 31 岁女性,头痛、右眼视力下降、眼球活动疼痛。经检查,右眼无突眼,右眼存在 RAPD,触诊时有压痛。CEMRI 显示眼眶顶部有弥漫性浸润病变,提示炎症性病变。病例 2 是一名 40 岁的男性,左眼也有类似症状,CECT 显示左眼视神经和眼外肌水肿。经过详细检查,两名患者均被诊断为眼眶结核。他们开始接受 ATT 和口服类固醇治疗,但最初失去了随访机会,而且由于治疗延误,导致了不可逆的视力丧失。长期随访显示,患者的眼部症状有所缓解,但偶尔会出现头痛。
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来源期刊
CiteScore
3.80
自引率
3.40%
发文量
39
审稿时长
13 weeks
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