Panophthalmitis is one of rare manifestations of
tuberculosis described in atypical situations such as children, immune compromised patients, or
drug abuse. The present report describes the first case of tubercular
panophthalmitis developing after
trauma in an otherwise healthy adult patient. A 46-year-old female patient presented with corneal infiltrate and
endophthalmitis that developed after an injury to right eye with wooden object. Corneal scrapings and vitreous tap were sterile. The patient did not improve with
antibiotics and developed
panophthalmitis. On evisceration of the painful blind eye, histopathology showed the presence of granulomatous
inflammation and
acid-fast bacilli. The patient had no other systemic focus of tubercular
infection. The patient was managed with anti-tubercular
therapy for 6 months. Atypical presentations of
tuberculosis like
panophthalmitis pose a difficult problem in diagnosis as well as treatment. Direct inoculation of bacilli during
trauma is a rare source of
infection. This case report presents unusual development of tubercular
panophthalmitis following direct inoculation of bacilli during
trauma.
Ocular tuberculosis should be considered in differential diagnosis of posttraumatic
endophthalmitis and
panophthalmitis, especially in endemic regions like India.