A mid-60s woman's eye-movement and vision loss traced to tuberculosis meningitis
In the midwestern USA, a woman's orbital apex syndrome turned out to be tuberculosis meningitis, found only on dural biopsy.
Orbital apex syndrome means that several nerves crowded at the back of the eye socket stop working together. These are the optic nerve, the nerves that move the eye, and the first branch of the trigeminal nerve. Infections, inflammation and tumours can all cause it.
This case report describes a woman in her mid-60s living in the midwestern USA who presented with the syndrome. The underlying cause was tuberculosis meningitis. The diagnosis was established by a dural biopsy that showed necrotising granulomas and acid-fast bacilli. The authors note that tuberculosis at this site is rare and hard to recognise, especially in countries where tuberculosis is uncommon.
After 2 months of modified anti-tuberculosis therapy, her eye movements and visual acuity improved. As a single case, this report cannot show how common this presentation is or how most patients respond to treatment.
Summary prepared with AI assistance from the published abstract and reviewed by a physician. Not medical advice. Learn more
