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Ocular Manifestations

Ocular involvement occurs almost exclusively during active tuberculosis! Any ocular structure can be affected!

  • Iris, choroidal tubercles
  • Anterior uveitis
  • Iris nodules (Koeppe nodules at the pupillary margin)
  • Vitreous opacities
  • Choroiditis
  • Retinal periphlebitis
  • Panophthalmitis

Indications for Therapy

  • Active tuberculosis.
  • Latent tuberculosis only if < 35 years old or immunocompromised (e.g., HIV).


  • Genetic rifampicin resistance determination (GeneXpert® PCR) before starting treatment
    • Consult infectious disease specialist in case of resistance
  • Isoniazid 1×5 mg/kg body weight p.o., max. 300 mg for 6 months
    • + Rifampicin 1×10 mg/kg body weight p.o., max. 600 mg for 6 months
    • + Pyrazinamide 1×25 mg/kg body weight p.o., max. 2000 mg for 2 months
    • + Ethambutol 1×15–25 mg/kg body weight p.o., max. 2500mg for 2 months
      • May be stopped early in case of good sensitivity
  • CAUTION: Monitor transaminases after 2 and 4 weeks
  • If anterior uveitis responds well to only local steroid therapy, tuberculosis is likely not the cause

Side Effects


  • EyeWiki Tuberculosis Uveitis
  • Antibiotika-Richtlinien Inselspital Bern
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)