Clinical manifestations and outcome of tuberculous sclerokeratitis

Br J Ophthalmol. 2016 Sep;100(9):1301-3. doi: 10.1136/bjophthalmol-2015-307599. Epub 2015 Dec 23.


Aim: To study the clinical manifestations and outcome of patients with tuberculous sclerokeratitis treated with antituberculous therapy without concomitant use of systemic steroids.

Methods: We reviewed retrospectively the medical records of eight consecutive patients with tuberculous sclerokeratitis. Patients were treated unsuccessfully with topical and/or systemic steroids. They underwent complete ophthalmic examination, systemic evaluation, laboratory investigations and imaging. Tuberculin skin test was done with purified protein derivative (PPD) on all patients. The diagnosis of tuberculous sclerokeratitis was made based on clinical findings of scleritis with adjacent peripheral corneal stromal keratitis, positive PPD test of 15 mm of induration or more, response to antituberculous treatment (ATT) within 4 weeks and exclusion of other causes of sclerokeratitis. Antituberculous drugs were given for a minimum of 6 months without concomitant use of corticosteroids. The outcome measure was resolution of the ocular surface inflammation of the sclera and cornea.

Results: Eight consecutive patients with a diagnosis of tuberculous sclerokeratitis were included. There were one male and seven female patients. The mean age was 29 years with an age range of 7-43 years. The involvement of the sclera was nodular in six patients and diffuse in two. The involvement of the cornea consisted of peripheral corneal stromal inflammation adjacent to the area of scleritis. Patients responded to antituberculous medications with complete resolution of the sclerokeratitis without topical or systemic anti-inflammatory agents.

Conclusions: Antituberculous medications can lead to complete resolution of the sclerokeratitis without concomitant use of steroids, or other anti-inflammatory agents.

Keywords: Inflammation; Ocular surface; Sclera and Episclera.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Eye Segment / diagnostic imaging*
  • Antitubercular Agents / therapeutic use*
  • Child
  • Cornea / diagnostic imaging
  • Cornea / microbiology
  • Female
  • Follow-Up Studies
  • Humans
  • Keratitis / diagnosis*
  • Keratitis / drug therapy
  • Keratitis / microbiology
  • Male
  • Mycobacterium tuberculosis / isolation & purification*
  • Posterior Eye Segment / diagnostic imaging*
  • Retrospective Studies
  • Sclera / diagnostic imaging
  • Sclera / microbiology
  • Scleritis / diagnosis*
  • Scleritis / drug therapy
  • Scleritis / microbiology
  • Treatment Outcome
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / microbiology
  • Visual Acuity
  • Young Adult


  • Antitubercular Agents