Ciliary Body Tuberculosis Presenting with Attacks of Acute Intraocular Pressure Rise

To report a rare presentation of ophthalmic tuberculosis.

 A 19-year-old man was referred to the glaucoma clinic due to multiple attacks of increased intraocular pressure (IOP) in his right eye. IOP of the right eye was 50 mmHg, and glaucomatous damage of the optic nerve was present. In gonioscopy, an oval-black lesion was present in the ciliary body band on the temporal side, which looked like a granuloma in ultrasound biomicroscopy (UBM). After rejecting immunological diseases due to the 20mm tuberculin test, the diagnosis of ciliary body tuberculosis was made. The patient was treated with a multi-drug regimen for 9 months. After 4 weeks, IOP was normalized, and at the end of 9 months, the ciliary body granuloma disappeared.

Ciliary body tuberculosis can cause multiple attacks of acute IOP rise (possibly due to the release of pigment and necrotic debris). Systemic causes of glaucoma such as tuberculosis should be kept in mind, especially in unilateral cases, and performing a thorough gonioscopy is useful in this regard.