Abstract

A 22 year female presented with diminution of vision in left eye since 3 weeks. She had no history of systemic illness or Tuberculosis(Tb) contact. On examination, the vision was 6/6 in right eye and finger counting close to face with accurate projection of rays in left eye. Anterior segment was within normal limit and a choroidal mass was seen on posterior pole(no vitritis). A provisional diagnosis of a choroidal mass was made. At first, imaging showed 8x 5 mm with features suggestive of ? Choroidal melanoma. Within 2 days, it worsened and inferior exudative RD, with multiple retinal hemorrhages and vitritis was seen pointing towards an infective etiology.
The patient was investigated and was diagnosed with Tb. She was started on anti tubercular treatment(ATT) and oral steroids.
After 2 months, there was no improvement. The workup for drug resistance was done and once resistance was confirmed, the patient was started on drug resistant ATT after which signs and symptoms improved.