Conjunctival tuberculosis: causes, symptoms, diagnosis, treatment

Tuberculosis of the conjunctiva can develop during the primary infection of the conjunctiva (exogenous pathway), the transition of inflammation from the skin of the eyelids and the mucous membrane of the lacrimal sac, and hematogenous lymphogenous metastasis from other organs.

When exogenous lesions of tuberculosis granuloma contribute to the violation of the integrity of the mucous membrane. However, cases of tuberculous granuloma of the conjunctiva are described without damaging this envelope. In the inflammatory process, as a rule, pre-limphatic glands are involved. Most often the mucous membrane of the upper eyelid is affected, where grayish nodules appear with a tendency to caseous and ulcer development. Clinical signs of inflammation are moderately pronounced. The ulcer usually has an irregular shape, it can spread to the cartilage and muscle tissue of the eyelid: its bottom is tuberous, with dented edges and greasy exudate.

Characteristic of a prolonged torpid flow. With an unfavorable progressive form, it is possible to destroy the eyelid, followed by its deformation and the development of a lagophthalmus. During the period of antibacterial treatment and chemotherapy, such a course is extremely rare. Diagnosis should include a bacteriological, cytological examination, a biopsy of the affected tissue and parotid lymph nodes. Differential diagnosis should be performed with a syphilitic etiology (solid chancre) and neoplasm (basal cell or squamous cell carcinoma).

Epibulbar tuberculosis. In the thickness of the conjunctiva and the superficial layers of the sclera in the limb region or yellowish-pink nodules appear perilymbalno. In some cases, their surface is ulcerated. Such infiltrates are tuberculosis granules. In these forms, hematogenous metastation can not be excluded. However, the vascular tract of the eye remains intact. The disease is observed against tuberculous intoxication. It is also possible to introduce mycobacterium tuberculosis into the thickness of the conjunctiva from the vessels of the perimelbital network.