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To the Editor The choroidal tubercle (figure 1) may be the most common manifestation of ocular tuberculosis (TB), and one of the earliest signs of disseminated infection.1 Fuchs described the value of eye examination for detection of choroidal tubercles and diagnosis of disseminated tuberculosis in his textbook over a century ago. About half a century later, an autopsy study of miliary tuberculosis in children found that eye examination exceeded chest radiography in diagnostic sensitivity: choroidal tubercles were found in 25/48 (52.1%) of children; positive chest radiography in 18/52 (34.6%).2
In the AIDS era, there have been conflicting reports about ocular TB. For instance, in India, a retrospective AIDS case series from a tertiary care eye referral centre in Chennai reported it occurring rarely, in under 2% of patients,3 whereas, a prospective cross-sectional study from an AIDS clinic in Mumbai reported ocular TB in 23.5% of patients.4
Disseminated TB occurs …
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