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Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 537-539

Paradoxical reaction presenting with orbital signs in possible intraocular tuberculosis: A case report

1 Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
2 Rainbow Children Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Suganeswari Ganesan
Shri Bhagwan Mahavir Vitreoretinal Services, Medical Reasearch Foundation, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai, Tamil Nadu - 600 006
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1738_21

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We report an unusual presentation of paradoxical reaction (PR) with orbital signs in a case of possible intraocular tuberculosis (POTB). A 15-year-old boy presented with vitreous hemorrhage in the right eye (OD) and multifocal choroiditis in the left eye (OS) and progressed to develop bilateral proptosis, lid edema, chemosis, subretinal lesions, and progression of choroidal lesions following the rapid tapering of oral steroids with anti-tubercular therapy for POTB. The orbital reaction and progressing posterior segment lesions were managed with pulse steroid therapy, oral steroids, intravitreal anti-vascular endothelial growth factor (anti-VEGF), and steroid implant. The orbital involvement is rarely seen in POTB with PR.

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