Abstract
Objective: Report a case report of tuberculous episcleritis and the clinical challenges to make the diagnosis. Case details: Male patient, 20 years old, born and resident of the State of Tocantins and with psoriatic spondylitis. He sought eye care complaining of irritation in the left eye for 20 days with an accumulation of morning secretion. Ocular biomicroscopy was performed and revealed a clinical picture of nonspecific active chronic conjunctivitis, not responding to the initial treatment. Biopsy of the lesion was performed with research for fungi, with the presence of these. Treatment for fungal infection was prescribed, which improved with subsequent clinical worsening. A new biopsy was performed, which revealed inflammation, without hyphae, and the hypothesis of ocular tuberculosis was considered. PPD was performed, which resulted in a 21mm reaction, and specific treatment was instituted with resolution of the condition, concluding the diagnosis of tuberculous episcleritis. Final considerations: Tuberculosis is highly prevalent in Brazil and may have pulmonary and extrapulmonary manifestations, such as ocular tuberculosis. As shown, there is difficulty in diagnosing this pathology and, therefore, this report intends to draw the attention of health professionals to its diagnosis.