Tubercular Nodular Episcleritis: A Case Report

Episcleritis is a common inflammatory eye illness that is typically self-limiting and is marked by mild discomfort and redness. However, systemic disorders, such as infections like tuberculosis (TB), may be linked to recurring or treatment-resistant episcleritis. Localized, elevated lesions on the bulbar conjunctiva are a symptom of the uncommon form of tubercular nodular episcleritis, which may be a sign of systemic TB. The patient was a 40-year-old woman who had been experiencing slight discomfort, redness in her right eye, and a raised lesion near her limbus for 15 days. These symptoms were indicative of nodular episcleritis. She developed a slight cough and was lethargic after the first round of treatment with antibiotics and corticosteroid eye drops failed. Tuberculosis was diagnosed after a highly positive Mantoux test revealed tuberculosis. Topical corticosteroids (loteprednol etabonate 0.5%) and oral NSAIDs were used to treat the condition. Isoniazid, Rifampin, Pyrazinamide, and Ethambutol were started as part of systemic anti-tubercular therapy (ATT) due to the positive Mantoux test and repeated symptoms. To track side effects and therapeutic efficacy, close monitoring was advised. This case highlights how crucial it is to take tuberculosis into account when making a differential diagnosis for recurring episcleritis, especially in endemic locations. In order to avoid problems and enhance patient outcomes, early diagnosis and focused treatment are essential. Keywords: Episcleritis, tuberculosis, mantoux test, systemic anti-tubercular therapy