“UNTREATED TB CAN STEAL YOUR SIGHT”: PHYSICIANS WARN OF IRREVERSIBLE BLINDNESS

Physicians have issued a stark warning about the devastating ocular complications of untreated tuberculosis, revealing that the disease can spread beyond the lungs to the eyes, causing severe visual impairment and irreversible blindness.

The warning comes as Nigerian ophthalmologists raise alarm over the under-diagnosis of ocular TB, a condition that was long thought to be rare but is now believed to be far more prevalent than official figures suggest, ValidViewNetwork reports.

THE SILENT THREAT

Tuberculosis is primarily known as a disease of the lungs. But Mycobacterium tuberculosis can disseminate through the bloodstream and affect almost any part of the body, including the eye.

Ocular TB can manifest as uveitis, choroidal granulomas, optic nerve involvement, and in severe cases, panophthalmitis—a blinding infection of the entire eye .

The symptoms are insidious. Blurred vision. Eye pain. Floaters. Redness. And eventually, blindness.

According to Dr Yewande Babalola, an ophthalmologist and vitreoretinal surgeon in Ibadan, Nigeria, the condition is routinely missed because doctors do not think to look for it.

She recounted the case of a 43-year-old woman who came to her clinic with poor vision in one eye. When Babalola examined the back of the eye, she saw scars that reminded her of what she had seen during her fellowship training in India.

“So I asked her, ‘Have you ever had pulmonary TB?’ And she looked at me like I was a magician,” Babalola told Stanford Global Health.

Her patient had been treated for TB five years earlier .

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THE MISSED DIAGNOSES

The scale of the problem is unknown. The only prior ocular TB study in Nigeria, published nearly two decades ago, revealed a 9.8% prevalence in Benin City.

But Babalola suspects the current numbers are much higher.

In 2023, another patient arrived at her clinic with a diagnosis of optic atrophy and an epiretinal membrane. When Babalola examined him closely, she saw yellow lesions at the back of his eye.

“Not even thinking, I just said, ‘Well, if I didn’t know better, I would think it was TB,'” she recalled.

The patient tested negative for pulmonary TB, but further tests confirmed Babalola’s suspicion. Other members of his family had been treated for TB .

“Those two cases would have otherwise been missed,” she said. “I realized we may have ocular TB much more than we actually know” .

THE CONSEQUENCE

If ocular TB is left untreated, the inflammation can destroy the structures of the eye. In severe cases, the eye may perforate spontaneously. The result is irreversible blindness .

The tragedy is that ocular TB is treatable with standard anti-tubercular therapy. But treatment must begin early, before the damage becomes permanent.

WHY IT MATTERS

Nigeria has one of the highest burdens of tuberculosis in the world. Millions of Nigerians are infected, and many are undiagnosed or untreated.If the disease can spread to the eyes, then every untreated TB patient is at risk of losing their sight.

And every doctor who fails to consider ocular TB is missing an opportunity to save a patient’s vision.

Dr Babalola has since participated in the Stanford African Scholars in Global Health program to study ocular TB and develop screening protocols. She is now working to raise awareness among Nigerian physicians and health workers .

But awareness is not enough. Screening is not enough. What is needed is a system that catches ocular TB early, treats it promptly, and prevents the irreversible loss of sight.

The warning has been issued. The question is whether Nigeria’s health system will listen. ValidViewNetwork reports.