Abstract

36 year old female presented with diminished vision in Both Eyes,pain,redness and photophobia in Left Eye. She had similar episodes on and off in Both Eyes for the past 8 years.  Examination showed extensive Pannus and Corneal thinning in Right Eye and  2 Corneal Phlyctenular Ulcers in the Left Eye. On investigation, she had Mediastinal Lymphadenopathy, tested positive for Mantoux and QuantiFERON gold. A diagnosis of Extrapulmonary Tuberculosis with Bilateral Tuberculous Phlyctenular Keratoconjunctivitis was made. She was started on topical Steroids,Antibiotics and Cycloplegics, Anti Tuberculous Therapy (ATT) was initiated concurrently. Clinical improvement was seen. 2 months later, the patient presented as ATT Defaulter with full blown Bilateral Corneal and Conjunctival Phlyctenules with characteristic lesions like ‘Marching Corneal Phlycten’ and ‘Wandering Pannus’. With re-initiation of topical and systemic therapy, the disease resolved and settled with minimal Corneal scarring.