Purpose: To report cases of tuberculous choroidal granuloma in retroviral negative South African Indians with no obvious systemic illness with a view to emphasizing the need for high clinical index of suspicion in the management of patients in tuberculosis endemic areas. Methods: This is a case report. Patients: Ophthalmic patients referred from a Provincial Eye Hospital for complaints of poor vision and subretinal lesions. Results: A presumptive diagnosis of tuberculous (TB) choroidal granuloma was made in both cases based a high index of suspicion. Both cases responded positively to empirical treatments with antituberculosis medications. Discussion/Conclusion: Tuberculous choroidal granuloma usually occurs following a systemic spread to the choroid. In the absence of systemic signs/symptoms and negative laboratory investigations, a positive response to anti TB medication is confirmatory. A high index of suspicion is needed in TB endemic areas.
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