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Letter
Bilateral disciform keratitis as the presenting feature of extrapulmonary tuberculosis
  1. Ritu Arora,
  2. Sachin Mehta,
  3. Deepa Gupta,
  4. Jawaharlal Goyal
  1. Department of Ophthalmology, Guru Nanak Eye Centre & Maulana Azad Medical College, New Delhi, India
  1. Correspondence toDr Sachin Mehta, Department of Ophthalmology, Guru Nanak Eye Centre & Maulana Azad Medical College, Flat no 8, Radheshyam, Jivdayalane, Ghatkopar West, Mumbai 400086, India; sachu_mehta{at}hotmail.com

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An 11-year-old girl apparently in good health presented with a bilateral decrease in vision for 1 week. Visual acuity was 20/200 (both eyes). Slit-lamp biomicroscopy of the cornea showed a well-defined disc (8 mm) of stromal inflammation and no associated vascularisation (figure 1A,B). The corneal sensations were normal. A few keratic precipitates were present on the endothelium within the involved area of stromal oedema (arrows in figure 1A,B). A diagnosis of bilateral disciform keratitis was considered. A trial of topical prednisolone acetate 1% four times daily was instituted. There was only marginal improvement in corneal oedema at 1 week. There was no previous history of ocular herpes, mumps, measles, varicella or cat-scratch disease. A reading of 26 mm erythema and induration on the left forearm was obtained with purified protein derivative testing with …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.