Revealing the Uncommon: Uveitic Glaucoma as a Distinctive Manifestation of Ocular Tuberculosis

Abstract

Abstract Background: This case report presents a woman who recently immigrated to the United States, referred for evaluation of unspecified glaucoma. The aim is to outline her clinical presentation, while emphasizing the complexities in diagnosing and management. Case presentation: The patient presented with a history of glaucoma diagnosed three years earlier in Senegal, resulting in vision loss in her right eye. The diagnostic evaluation included various ophthalmic assessments, including intraocular pressure (IOP) measurements, pachymetry, gonioscopy, slit-lamp examination, and dilated fundus examinations. Ophthalmic evaluations revealed signs of uveitic glaucoma, including pigmented keratic precipitates, anterior chamber cell, lens anomalies, and pigmented anterior vitreous cell. A comprehensive systemic investigation was undertaken, involving diverse blood tests and imaging, to identify the underlying cause of her uveitic glaucoma. Systemic analysis uncovered a positive QuantiFERON TB Gold test and positive ANA testing, while other tests ruled out alternative diagnoses. The patient diagnosed with tuberculous uveitis and initiated a course of anti-tuberculosis medications. At the 3-month follow-up, her IOP remained stable, and the uveitis was inactive. By the 6-month, her left eye showed subjective improvement in vision, while her right eye's vision remained unchanged, and IOP measurements had normalized. Conclusion: This case underscores the significance of considering tuberculosis as a potential cause of uveitis without significant involvement in other organs, and the intricacies of managing such cases, particularly in pregnant individuals. Timely diagnosis and appropriate treatment can enhance outcomes for patients with tuberculous uveitis.