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TUBERCULOMA OF LEFT LATERAL RECTUS IN ORBIT
T Bramhabhatt
Hon. Asst Prof., Dept of Ophthalmology, Grant Medical College, Mumbai.
INTRODUCTIONSwelling in the orbital muscles is not an uncommon presentation. One of such cases is described below.
Case Report
A 27 year old female came with a history of swelling over the lateral side of her left eye of about a year’s duration. The swelling was painful and was seen to increase in size. The general condition of the patient was good and there was no history of medical illnesses in the past.
On examination, the left eye appeared inflamed in the region of the lateral rectus muscle. There was restriction of abduction of that eye. Other extra ocular movements were normal. Vision of the eye was 6/6 unaided. The anterior segment appeared normal except for the conjunctival hyperaemia. Fundoscopy revealed no abnormality. Haematological examination revealed haemoglobin 10.5 gm%, WBC 11,500/c.mm neutrophils 75%, eosinophils 3%. Mantoux test was mildly positive. X-ray chest was normal. USG revealed a cystic mass at the insertion of the right lateral rectus.
A tentative diagnosis of cysticercosis was made in view of the cystic nature of the lesion. It was decided to excise the lesion. At surgery - the lesion was seen sitting over the insertion of the lateral rectus.
The lesion was excised enmasse and sent for histopathological examination. The specimen was reported as a tuberculoma.
DISCUSSION
Tuberculoma involving the extra ocular muscle is a very rare presentation. However, in our country since tuberculosis is known to involve many extra pulmonary sites like brain, thyroid, lymph glands, breast, testicle, ovaries, skin, etc. It is not surprising that in our case this swelling of the lateral rectus turned out to be tuberculoma.
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