Abstract

Background: Intracranial tuberculoma as one of the central nervous system manifestations of tuberculosis can cause various ophthalmic manifestations. Papilledema is commonly found as an initial ophthalmic manifestation of a space-occupying lesion such as tuberculoma before any visual deterioration occurs. This study aims to report a case of multiple tuberculomas revealed by papilledema in a post-pulmonary tuberculosis patient. Case Presentation: A 32-year-old woman came with a chief complaint of vision loss in both eyes for three weeks associated with headache, nausea, and vomiting. She had a history of bacteriologically confirmed pulmonary tuberculosis 10 months prior to the presentation and had completed the treatment. There was no history of seizure, limb weakness, and loss of consciousness. Ophthalmological examination showed the visual acuity was 1/300 in the right eye and 2/60 in the left eye. There was a slight limitation of abduction of the left eye with normal eye movements to other directions. Pupils were round with decreased direct and indirect light reflexes. Funduscopic examination showed bilateral optic disc swelling with an elevated and blurred margin of the optic discs and obscuration of one large vessel which was consistent with Frisen grade III papilledema. CT scan of the brain orbit revealed multiple nodules with rim enhancement accompanied by perifocal edema suggestive of intracranial tuberculoma lesions. Conclusion: The presentation of papilledema in a post-pulmonary tuberculosis patient can be useful in the early detection of central nervous system diseases such as tuberculoma