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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}

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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.