A 32-year-old man developed unilateral visual loss. Disseminated large choroidal nodules and granulomatous optic neuropathy were observed in one eye and responded to antituberculous therapy with return of vision. There was no clinical evidence of extraocular tuberculosis. Disseminated choroiditis can be the presenting sign in tuberculosis and the single accessible yet non-invasive evidence for spread of the mycobacteria.