Mycobacterium tuberculosis can infect many extrapulmonary organs, including the eyes. It is a common infectious cause of uveitis in certain, mostly tropical, countries. HIV-infected patients are particularly at risk to disease.
Ocular manifestations include choroidal granuloma, choroiditis, chorioretinitis, optic nerve infiltration, and uveitis (Figs 18.2.1 and 18.2.2). Choroidal involvement can cause a large plaque in the posterior pole, similar to that seen in serpiginous choroiditis, or can be multifocal in nature. Multiple old, inactive associated chorioretinal scars are suggestive of tuberculosis.