DR. ANAMIKA PANDEY

DR. AYUSHI OJHA, DR.DR. SYED FARAAZ HUSSAIN, DR. YOGYA REDDY

Abstract

Visual impairment is one of the most devastating complications of a patient with CNS TB .Here we present a case of a 17 year old immunocompetent male with Retrobulbar neuritis with pulmonary and CNS TB presenting with bilateral visual loss. A definitive diagnosis of pulmonary Tb was made through Bronchoalveolar lavage. The patient was diagnosed with CNS TB on the basis of Neuroimaging which showed tuberculomas and on the basis of CSF analysis a diagnosis of TB meningitis was made. The patient was started on ATT with no visual improvement and a rather worsening of vision. Bitemporal field depression and an abnormal RNFL analysis was seen on the OCT. VEP in both eyes was suggestive of a slowed conduction along bilateral optic pathways. Patient was started on IV steroids and showed dramatic improvement in vision. A rather elusive case, the diagnosis was uncovered through an extensive ophthalmic evaluation.