Resurgence of tuberculosis in the developed world as a result of immigration, acquired immunodeficiency syndrome, and drug resistance has led to improved methods of diagnosis.
Mycobacterium tuberculosis can be difficult to isolate in vitro.
We describe 3 patients with ocular disease in whom routine investigations failed to identify systemic tuberculous infection. In 1 patient, initial misdiagnosis had serious consequences. The use of PCR on aqueous humor samples from 2 other patients confirmed the diagnosis and they received prompt treatment. To our knowledge, this is the first report of patients without acquired immunodeficiency syndrome being diagnosed with ocular TB with no evidence of systemic disease, in whom PCR testing established the diagnosis. No acid-fast bacilli were seen.