Madge, S.Prabhakaran, V.Shome, D.Kim, U.Honavar, S.Selva-Nayagam, D.2009-11-172009-11-172008Orbit: the international journal on orbital disorders, oculoplastic and lacrimal surgery, 2008; 27(4):267-2770167-68301744-5108http://hdl.handle.net/2440/53414Purpose: To provide an up-to-date review of the clinical presentations, investigations, and management of orbital tuberculosis (OTB). Methods: Systematic review of the literature concerning OTB, limiting the results to English-language peer-reviewed journals. Results: Seventy-nine patients from 39 publications were identified as cases of OTB. The condition presents in one of five forms: classical periostitis; orbital soft tissue tuberculoma or cold abscess, with no bony involvement; OTB with bony involvement; spread from the paranasal sinuses; and tuberculous dacryoadenitis. The ocular adnexa, including the nasolacrimal system and overlying skin, may also be involved. Conclusions: Diagnosis can be difficult and may necessitate an orbital biopsy, in which acid-fast bacilli (AFB) and characteristic histopathology may be seen. Growth of Mycobacterium tuberculosis (mTB) from such a specimen remains the gold standard for diagnosis. Ancillary investigations include tuberculin skin tests and chest radiography, but more recently alternatives such as whole blood interferon-γ immunological tests and PCR-based tests of pathological specimens have proven useful. The management of OTB is complex, requiring a stringent public health strategy and high levels of patient adherence, combined with long courses of multiple anti-tuberculous medications. The interaction of the human immunodeficiency virus (HIV) with TB may further complicate management.enOrbittuberculosisTBmycobacteriaJournal article002008383310.1080/016768308022251522-s2.0-5004911841941135Selva-Nayagam, D. [0000-0002-2169-5417]