Ocular Tuberculosis: Unilateral, Asymmetric, and Varied in Presentation

Tuberculosis is an infectious illness that can causes substantial morbidity and mortality globally. It is a “great masquerader,” as it can affect any organ system, in a variety of manifestations. The eye is no exception. Ocular tuberculosis can affect any part of the eye: the anterior segment, posterior segment, or adnexa. A common ocular manifestation is choroiditis. However, it may also present as panuveitis, retinal vasculitis, and neuroretinitis. Involvement of the posterior segment can produce substantial inflammation, increasing the risk of damage to the neurosensory retina, optic nerve, and surrounding tissues, resulting in irreversible vision loss. Thus, it is imperative to identify ocular tuberculosis as early as possible to initiate vision-saving treatment. Here, we present two cases of tuberculous chorioretinitis that demonstrate the wide spectrum of clinical presentation of posterior segment ocular involvement and its characteristic of being asymmetric or unilateral. These cases exemplify the importance of maintaining TB on a broad differential diagnosis of ocular inflammation.