A 65-year-old Ecuadorian woman, with no personal or family history of interest, came to the ophthalmology outpatient clinic for a painless decrease in vision in the right eye (OD) of 3 to 4 months' duration. The maximum visual acuity (VA) in the right eye was 0.5 and in the left eye (LO) it was 1. Extrinsic and intrinsic motility was normal. In the OD there was papillary oedema with some subretinal exudate. CT and orbito-cerebral MRI, luetic serology, angiotensin converting enzyme, Lyme serology and chest X-ray were negative. The systemic apparatus study was not significant. Mantoux (PPD), already in the first 24 hours, had a 25 mm induration with areas of dermal necrosis. Chest X-ray was repeated and was also negative. CSF puncture showed an outflow pressure of 16 cm H2O with normal biochemistry and negative culture. CSF electrophoresis was performed and no oligoclonal bands were detected. Urine culture and sputum culture were also negative for mycobacterium tuberculosis growth. Suspected ocular tuberculosis was tested with isoniazid 300 mg/day for 3 weeks with subjective improvement in OD vision although maximum vision was still 0.5. He was treated with isoniazid 300 mg (9 months) together with rifampicin 600 mg (9 months), pyrazinamide 15 mg/kg (2 months) and ethambutol 15 mg/kg (2 months). One year after the first consultation the OD's visual acuity was 0.9 and his examination was normal.