Tuberculous Blepharitis Following Removal of Intracanalicular Lacrimal Plug

ABSTRACT

PURPOSE: Diagnosis of tuberculous blepharitis may be delayed because of its nonspecific symptoms such as periocular edema, nodule, and papule. By investigating the route of infection and clinical course of tuberculous blepharitis, it was attempted to emphasize the importance of early diagnosis and treatment. METHODS: After the trial of intracanalicular plug removal, lid edema and nodule were developed in the patient who had been implanted a intracanalicular plug for dry eye. Excisional biopsy of the lesion was performed after treatment trial with local injection of triamcinolone acetonide. Many acid-fast bacilli were found in the microscopic examination. The patient underwent 9-month-scheduled anti-tuberculous medication. RESULTS: The lesion has improved with the medication. Lid ectropion occurred at the site of biopsy. CONCLUSIONS: Tuberculous blepharitis can be developed as a complication of intracanalicular plug procedure for dry eye. Tuberculous infection should be considered as a possible cause of longstanding blepharitis that is unresponsive to supportive treatment. It is emphasized that early diagnosis and proper management are important.