New Insights into the Diagnosis and Prognosis of Eye Diseases

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (31 August 2026) | Viewed by 15184

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Guest Editor
Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy
Interests: cataract surgery; intraocular lenses (IOLs); corneal diseases; astigmatism; dry eye; corneal surgical procedures (keratoplasty)
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Guest Editor
Department of Medicine, Surgery and Health Sciences, University Eye Clinic of Trieste, 34100 Trieste, Italy
Interests: vitreoretinal surgery; glaucoma surgery; corneal surgical procedures (keratoplasty); anterior and posterior segment diseases; eye trauma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, titled "New Insights into the Diagnosis and Prognosis of Eye Diseases", delves into the latest advancements and breakthroughs in understanding and managing ocular conditions. It brings together cutting-edge research, clinical case studies, and expert perspectives that highlight innovative diagnostic techniques, improved treatment modalities, and refined prognostic models. This Special Issue aims to empower healthcare professionals with the knowledge to enhance patient outcomes and drive progress in the field of eye care.

Dr. Rosa Giglio
Prof. Dr. Daniele Tognetto
Guest Editors

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Keywords

  • diagnosis
  • prognosis
  • eye diseases
  • markers
  • clinical practice and patient care

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Published Papers (11 papers)

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Research

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21 pages, 754 KB  
Article
Quantitative Assessment of Anterior Segment OCT Parameters and Their Association with Intraocular Pressure in Primary Angle-Closure Disease
by Alina-Gabriela Gheorghe, Tudor-George Potop, Dana-Margareta-Cornelia Dascalescu, Maria-Cristina Marinescu, Christiana-Diana-Maria Dragosloveanu, Ana-Maria Arghirescu, Ioana-Maria Rizea and Vasile Potop
Diagnostics 2026, 16(16), 2496; https://doi.org/10.3390/diagnostics16162496 - 7 Aug 2026
Viewed by 389
Abstract
Background/Objectives: Glaucoma represents a progressive optic neuropathy and is the leading cause of irreversible blindness worldwide. The disease is classified as primary angle-closure glaucoma (PACG) or as primary open-angle glaucoma (POAG) depending on the iridocorneal angle. Although gonioscopy remains the gold standard [...] Read more.
Background/Objectives: Glaucoma represents a progressive optic neuropathy and is the leading cause of irreversible blindness worldwide. The disease is classified as primary angle-closure glaucoma (PACG) or as primary open-angle glaucoma (POAG) depending on the iridocorneal angle. Although gonioscopy remains the gold standard investigation, anterior segment optical coherence tomography (AS-OCT) may provide important data about these structures, offering a quantitative assessment of the angle. The purpose of this study is to evaluate AS-OCT parameters in patients with primary angle-closure disease (PACD). Methods: This retrospective exploratory study included 75 eyes from 60 patients with PACD, classified as primary-angle closure suspect (PACS), primary-angle closure (PAC) and PACG. Participants underwent comprehensive ophthalmic examination: best-corrected visual acuity (BCVA), gonioscopy, AS-OCT, optic nerve OCT, visual field examination, and specular microscopy. Associations between AS-OCT angle parameters, intraocular pressure (IOP), and ocular biometrics were assessed using correlation analyses with Benjamini–Hochberg correction for the primary analyses and generalized estimating equation (GEE) models to account for inter-eye correlation. Results: In the overall PACD cohort, AS-OCT angle parameters were inversely associated with IOP, with all primary correlations remaining significant after multiple-testing correction. GEE analysis confirmed significant associations for TISA500, AOD500, and AOD750. Exploratory analyses in the PACS, PAC and PACG subgroups were not significant after correction for multiple testing, while anterior segment biometric parameters showed expected intercorrelations. Conclusions: Quantitative angle parameters demonstrated robust inverse associations with IOP in the overall PACD cohort. These exploratory findings support the complementary role of AS-OCT in the PACD anatomical evaluation and warrant confirmation in larger prospective studies to determine their clinical and prognostic relevance. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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12 pages, 503 KB  
Article
Impact of Prior Diabetic Retinal Screening on Hospitalization and Ophthalmic Follow-Up in Diabetic Patients with Newly Diagnosed Proliferative Diabetic Retinopathy
by Charles Zhang, Neel R. Sonik, Zoe J. Tsoukas, Jonathan B. Lin, Georges AbouKasm, Jason C. Fan and Ninel Z. Gregori
Diagnostics 2026, 16(10), 1562; https://doi.org/10.3390/diagnostics16101562 - 21 May 2026
Viewed by 686
Abstract
Background/Objectives: This retrospective cohort study compared hospitalization and follow-up rates in patients with newly diagnosed proliferative diabetic retinopathy (PDR) versus those without prior diabetic retinopathy (DR) screening. Methods: Using TriNetX, a global electronic health record database, 57,964 patients aged ≥ 40 years [...] Read more.
Background/Objectives: This retrospective cohort study compared hospitalization and follow-up rates in patients with newly diagnosed proliferative diabetic retinopathy (PDR) versus those without prior diabetic retinopathy (DR) screening. Methods: Using TriNetX, a global electronic health record database, 57,964 patients aged ≥ 40 years with type 2 diabetes and newly diagnosed PDR without diabetic macular edema (DME) requiring panretinal photocoagulation or intravitreal injection were included. Patients were stratified based on the presence or absence of prior DR screening in the last 5 years and balanced using propensity score matching (PSM). Primary outcomes included 30-, 60-, and 90-day hospitalization rates and repeat ophthalmic follow-up as estimated using repeat PDR diagnosis codes and repeat retinal imaging codes, including OCT, fundus photography, and fluorescein angiography. Results: Of 57,964 patients, 25,003 had no prior DR screening and 32,961 had prior DR screening. After matching, 19,316 patients were included per cohort. Patients without known DR screening had significantly higher hospitalization rates at 30 days (RR = 1.78, 95% CI 1.67–1.89), 60 days (RR = 1.59, 95% CI 1.51–1.67), and 90 days (RR = 1.51, 95% CI 1.44–1.58), and lower repeat ophthalmic visits by PDR codes at 30 days (RR = 0.458, 95% CI 0.440–0.476), 60 days (RR = 0.450, 95% CI 0.437–0.463) and 90 days (RR = 0.420, 95% CI 0.408–0.432) or by repeat retinal imaging codes at 30 days (RR = 0.450, 95% CI 0.423–0.478), 60 days (RR = 0.394, 95% CI 0.377–0.411), and 90 days (RR = 0.381, 95% CI 0.366–0.396) (all p < 0.0001). Conclusions: Absence of known prior DR screening in PDR patients is associated with higher hospitalization risk and reduced ophthalmic follow-up, suggesting that a lack of screening indicates broader gaps in healthcare engagement and disease control. Tailored strategies are needed to prevent vision loss as well as systemic complications. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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13 pages, 709 KB  
Article
Prevalence of Diabetes Among First-Time Ophthalmology Patients at a Nonprofit Hospital in Mexico
by Valeria Sánchez-Huerta, Mary Lady González Suriel, Héctor Randolph, María José Barragán Álvarez and Benjamin Aleman-Castilla
Diagnostics 2025, 15(22), 2922; https://doi.org/10.3390/diagnostics15222922 - 19 Nov 2025
Viewed by 1210
Abstract
Background/Objectives: Diabetes is Mexico’s second-leading cause of death, primary cause of disability, and diabetic retinopathy (DR) associated with this disease is the leading cause of vision loss among the working population. Limited healthcare funding and inequitable access hinder diagnosis and treatment, leaving [...] Read more.
Background/Objectives: Diabetes is Mexico’s second-leading cause of death, primary cause of disability, and diabetic retinopathy (DR) associated with this disease is the leading cause of vision loss among the working population. Limited healthcare funding and inequitable access hinder diagnosis and treatment, leaving 32% undiagnosed and at risk of developing serious complications such as DR. With screening rates declining, nonprofits like the Association to Prevent Blindness in Mexico (APEC) play a crucial role in detecting diabetes and DR, reducing healthcare costs, and improving patient outcomes. Methods: This study analyzes data from over 25,000 first-time patients screened at APEC in 2023, providing a unique empirical resource on diabetes and DR in Mexico. Using the Social Return on Investment (SROI) approach, it evaluates program costs (medical resources, equipment, and personnel) against patient benefits. These benefits are quantified as the probability that newly diagnosed or uncontrolled diabetes patients begin treatment, thus preventing DR, weighted by the Value of Statistical Life (VSL). Results: Of the total screened patients, 17.2% had diabetes. Among them, 20.0% were unaware of their condition, while the remaining 80.0% knew their diagnosis. Notably, 25.8% of those who were aware of their diagnosis did not have diabetes under control. Considering all costs associated with the first-time ophthalmology patients screening program and assuming only a portion of patients would seek treatment, every peso invested by APEC has the potential to generate the equivalent to 542 pesos in patient well-being. When factoring in the subsequent costs of diabetes control treatment borne by the patients, the potential Benefit–Cost Ratio is estimated at 9:1. These results proved consistent to sensitivity analysis for key assumptions affecting the estimated benefits and costs. Conclusions: The study demonstrates that integrating routine diabetes screening into specialized ophthalmologic care can generate substantial social value through timely intervention, as early detection promotes better diabetes management and helps prevent complications beyond diabetic retinopathy. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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17 pages, 4186 KB  
Article
A Revised Concept for Ocular Surface Imprinting: Easy-to-Use Device for Morphological and Biomolecular-Based Differential Diagnosis
by Bijorn Omar Balzamino, Ilaria Ghezzi, Roberto Sgrulletta, Rossella Anna Maria Colabelli Gisoldi, Augusto Pocobelli, Antonio Di Zazzo, Loredana Zollo and Alessandra Micera
Diagnostics 2025, 15(20), 2660; https://doi.org/10.3390/diagnostics15202660 - 21 Oct 2025
Viewed by 1108
Abstract
Background/objectives: The continuous necessity to support biostrumental data with biolomecular data collected using non-invasive tools is influencing the world of ocular surface devices. The ocular imprint still represents a non-invasive and safety technique for collecting corneal and conjunctival epithelia in an easy way, [...] Read more.
Background/objectives: The continuous necessity to support biostrumental data with biolomecular data collected using non-invasive tools is influencing the world of ocular surface devices. The ocular imprint still represents a non-invasive and safety technique for collecting corneal and conjunctival epithelia in an easy way, as performed in human and veterinary clinics. Although used in clinical practice since 1977, operators might benefit from improvements in these techniques, especially in terms of handling and management. Methods: Herein, by reporting the design and characteristics of a patent of ocular surface sampling (the SurfAL pen and periocular-assisted SurfAL pen; PCT WO2016IB51474 20160316), we performed a validation and analysis of its value compared to gold standards. The level-headedness and advantages of this device were verified in 15 sclerocorneal specimens (sampling advantages) and tested in 25 volunteers (handling and operator efficiency, as well as frequency of discomfort in volunteers). Morphological as well as biomolecular analyses were used to compare SurfAL devices with conventional ones. Results: The easy management of SurfAL pens and the good detection of epithelial/goblet cells were confirmed. The SurfAL pen was found to be smart and suitable for routine analysis, as confirmed by quick and reproducible onsite sampling. Periocular-assisted SurfAL pen was comparable in terms of sampling quality but less comparable in terms of subject confidence due to its geometry. Conclusions: This study suggests that the SurfAL pen and periocular-assisted SurfAL pen might represent an additional and hands-on way of sampling ocular surface cells and improve the diagnostic route in ophthalmology. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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11 pages, 826 KB  
Article
A Novel Virtual Reality-Based System for Measuring Deviation Angle in Strabismus: A Prospective Study
by Jhih-Yi Lu, Yin-Cheng Liu, Jui-Bang Lu, Ming-Han Tsai, Wen-Ling Liao, I-Ming Wang, Hui-Ju Lin and Yu-Te Huang
Diagnostics 2025, 15(18), 2402; https://doi.org/10.3390/diagnostics15182402 - 20 Sep 2025
Cited by 1 | Viewed by 1547
Abstract
Background/Objectives: To develop a new Virtual Reality (VR) system software for measuring ocular deviation in strabismus patients. Methods: This prospective study included subjects with basic-type exotropia (XT) and non-refractive accommodative esotropia (ET). Ocular deviation was measured using the alternate prism cover [...] Read more.
Background/Objectives: To develop a new Virtual Reality (VR) system software for measuring ocular deviation in strabismus patients. Methods: This prospective study included subjects with basic-type exotropia (XT) and non-refractive accommodative esotropia (ET). Ocular deviation was measured using the alternate prism cover test (APCT) and two VR-based methods: target offset (TO) and a newly developed camera rotation (CR) method. Results: A total of 28 subjects were recruited (5 cases were excluded for preliminary testing and 5 for not meeting inclusion criteria). Among the 18 included patients, 10 (66.7%) had XT and 5 (33.3%) had ET. The median age was 21.5 years (IQR 17 to 25). The mean age was 22.3 years (range: 9–46), with 5 (27.8%) having manifest strabismus and 12 (61.1%) measured while wearing glasses. VR-based methods (TO and CR) showed comparable results to APCT for deviation angle measurements (p = 0.604). Subgroup analysis showed no significant differences in ET patients (all p > 0.05). In XT patients, both TO and CR underestimated deviation angles compared to APCT (p = 0.008 and p = 0.001, respectively), but no significant difference was observed between the two methods (p = 0.811). Linear regression showed CR had a stronger correlation with APCT than TO (R2 = 0.934 vs. 0.874). Conclusions: This newly developed VR system software, incorporating the CR method, provides a reliable approach for measuring ocular deviation. By shifting the entire visual scene rather than just the target, it lays a strong foundation for immersive diagnostic and therapeutic VR applications. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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9 pages, 451 KB  
Article
Novel Handheld Device for Remote Monitoring of Dry Macular Degeneration and Patient Usability Assessment
by Angela C. Yim, Lyna Azzouz and Yannis M. Paulus
Diagnostics 2025, 15(11), 1353; https://doi.org/10.3390/diagnostics15111353 - 28 May 2025
Cited by 1 | Viewed by 1410
Abstract
Background/Objectives: A novel, handheld, standalone device using shape discrimination hyperacuity has been developed to remotely monitor age-related macular degeneration (AMD). Methods: We clinically validated the device in an outpatient dry AMD population to evaluate its usability and comfort. A cross-sectional study was conducted [...] Read more.
Background/Objectives: A novel, handheld, standalone device using shape discrimination hyperacuity has been developed to remotely monitor age-related macular degeneration (AMD). Methods: We clinically validated the device in an outpatient dry AMD population to evaluate its usability and comfort. A cross-sectional study was conducted with subjects aged 50 years or older with dry AMD at the University of Michigan Kellogg Eye Center outpatient clinic after approval from the UM IRB (HUM00187177). Subjects used the device and then completed a device survey and System Usability Scale (SUS). Results: Thirty-one subjects completed the study, and one subject withdrew post-study completion (mean age 77 years, STD 8 years). The mean testing time was 126 s (STD 56 s), and the median was 116 s. Most patients reported that the use of the device occurred for an acceptable duration (97%), was easy (97%), and was comfortable (90%). The mean SUS score was 77.7 (STD 11.9). Conclusions: A handheld, standalone device can provide a rapid, easy, and comfortable testing solution for patients with dry AMD. The usability of the device supports further clinical trials to demonstrate the device’s ability to reliably detect the progression of AMD. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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11 pages, 2429 KB  
Article
Advancing Meibography Assessment and Automated Meibomian Gland Detection Using Gray Value Profiles
by Riccardo Forni, Ida Maruotto, Anna Zanuccoli, Riccardo Nicoletti, Luca Trimigno, Matteo Corbellino, Sònia Travé-Huarte, Giuseppe Giannaccare and Paolo Gargiulo
Diagnostics 2025, 15(10), 1199; https://doi.org/10.3390/diagnostics15101199 - 9 May 2025
Cited by 3 | Viewed by 2990
Abstract
Objective: This study introduces a novel method for the automated detection and quantification of meibomian gland morphology using gray value distribution profiles. The approach addresses limitations in traditional manual and deep learning-based meibography analysis, which are often time-consuming and prone to variability. [...] Read more.
Objective: This study introduces a novel method for the automated detection and quantification of meibomian gland morphology using gray value distribution profiles. The approach addresses limitations in traditional manual and deep learning-based meibography analysis, which are often time-consuming and prone to variability. Methods: This study enrolled 100 volunteers (mean age 40 ± 16 years, range 18–85) who suffered from dry eye and responded to the Ocular Surface Disease Index questionnaire for scoring ocular discomfort symptoms and infrared meibography for capturing imaging of meibomian glands. By leveraging pixel brightness variations, the algorithm provides real-time detection and classification of long, medium, and short meibomian glands, offering a quantitative assessment of gland atrophy. Results: A novel parameter, namely “atrophy index”, a quantitative measure of gland degeneration, is introduced. Atrophy index is the first instrumental measurement to assess single- and multiple-gland morphology. Conclusions: This tool provides a robust, scalable metric for integrating quantitative meibography into clinical practice, making it suitable for real-time screening and advancing the management of dry eyes owing to meibomian gland dysfunction. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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Review

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32 pages, 2013 KB  
Review
Dynamic Oculomics for Diagnostic Monitoring: Personal Ocular Trends, Risk Stratification and Treatment Response
by Alessandro Avitabile, Mario D. Toro, Roberta Amato, Dario Rusciano and Caterina Gagliano
Diagnostics 2026, 16(17), 2699; https://doi.org/10.3390/diagnostics16172699 - 24 Aug 2026
Viewed by 396
Abstract
Oculomics uses ocular images, ocular biofluids and functional ocular tests to extract diagnostic information on local or systemic biological states. Most current evidence is cross-sectional: one retinal photograph, OCT scan, OCTA examination or tear sample is compared with a reference population, or converted [...] Read more.
Oculomics uses ocular images, ocular biofluids and functional ocular tests to extract diagnostic information on local or systemic biological states. Most current evidence is cross-sectional: one retinal photograph, OCT scan, OCTA examination or tear sample is compared with a reference population, or converted into a diagnostic or prognostic score. This approach is useful for screening and risk enrichment, but it does not show whether the same patient is changing over time. In this review, dynamic oculomics, or oculomic kinetics, is presented as a diagnostic-monitoring approach based on repeated ocular measurements within the same individual. Its object is the personal trajectory: baseline level, short-term variability, long-term drift, response to stimulus, recovery and modification by treatment. We discuss the biological basis of ocular trajectories, the limits imposed by local ocular regulation and disease, and the technical constraints of fundus photography, structural OCT, OCTA, functional challenge tests, tear analysis, aqueous humour analysis, continuous intraocular pressure monitoring and home-based imaging. We also examine artificial intelligence, validation, governance, health-economic considerations and practical implementation. The available evidence does not support a universal ocular surrogate for systemic disease. More realistic applications include detection of unexpectedly rapid tissue change, individualised risk stratification, treatment-response assessment and recognition of discordance between systemic markers and ocular tissue behaviour. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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39 pages, 3117 KB  
Review
Tracer Techniques in Ophthalmology: Ocular Applications and Systemic Connections
by Xinxin Ye, Liting Zhao, Xiaodi Zhou, Wenyi Wu, Ying Lu, Yuanjun Li, Yewei Yin, Tu Hu and Dan Wen
Diagnostics 2026, 16(11), 1608; https://doi.org/10.3390/diagnostics16111608 - 25 May 2026
Viewed by 942
Abstract
Tracer techniques have emerged as pivotal tools in ophthalmology, offering unprecedented capabilities for visualizing and quantifying complex biological processes within the eye. These techniques—spanning optical, isotopic, and metal-based tracers—have significantly enhanced our ability to detect and monitor ocular diseases, from early-stage pathologies to [...] Read more.
Tracer techniques have emerged as pivotal tools in ophthalmology, offering unprecedented capabilities for visualizing and quantifying complex biological processes within the eye. These techniques—spanning optical, isotopic, and metal-based tracers—have significantly enhanced our ability to detect and monitor ocular diseases, from early-stage pathologies to therapeutic responses. By providing molecular-level specificity, improved signal sensitivity, and real-time dynamic imaging, tracers enable precise analysis of ocular fluid dynamics, retinal and vascular abnormalities, and neural connections between the eye and brain. Furthermore, these technologies are advancing our understanding of the systemic connections between the eye and other organs, such as the brain, thyroid, and lymphatic systems. Tracers are helping to uncover new pathways for understanding these relationships and their impact on both ocular and systemic diseases. Despite challenges in clinical translation, biosafety, and specificity, advances in tracer design, particularly at the nanoscale, are driving the development of multimodal imaging platforms. As these technologies continue to evolve, they will increasingly support the development of tailored treatment regimens, improve early detection, and facilitate the monitoring of therapeutic outcomes. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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16 pages, 1198 KB  
Review
Circulating Cell-Free DNA as an Epigenetic Biomarker for Early Diabetic Retinopathy: A Narrative Review
by Boaz Li, Megan M. Yim, Yu Xuan Jin, Brendan K. Tao, Jim S. Xie, Michael Balas, Haaris Khan, Wai-Ching Lam, Peng Yan and Eduardo V. Navajas
Diagnostics 2025, 15(9), 1161; https://doi.org/10.3390/diagnostics15091161 - 2 May 2025
Cited by 6 | Viewed by 3158
Abstract
Diabetic retinopathy (DR), a complication of type 2 diabetes mellitus (T2DM), is typically asymptomatic in its early stages. Diagnosis typically relies on routine fundoscopy for the clinical detection of microvascular abnormalities. However, permanent retinal damage may occur well before clinical signs are appreciable. [...] Read more.
Diabetic retinopathy (DR), a complication of type 2 diabetes mellitus (T2DM), is typically asymptomatic in its early stages. Diagnosis typically relies on routine fundoscopy for the clinical detection of microvascular abnormalities. However, permanent retinal damage may occur well before clinical signs are appreciable. In the early stages of DR, the retina undergoes distinct epigenetic changes, including DNA methylation and histone modifications. Recent evidence supports unique epigenetic ‘signatures’ in patients with DR compared to non-diabetic controls. These DNA ‘signature’ sequences may be specific to the retina and may circulate in peripheral blood in the form of cell-free DNA (cfDNA). In this review, we explore the literature and clinical application of cfDNA sampling as an early, non-invasive, accessible assessment tool for early DR detection. First, we summarize the known epigenetic signatures of DR. Next, we review current sequencing technologies used for cfDNA detection, such as magnetic bead-based enrichment, next-generation sequencing, and bisulfite sequencing. Finally, we outline the current research limitations and emerging areas of study which aim to improve the clinical utility of cfDNA for DR evaluation. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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Other

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10 pages, 1685 KB  
Case Report
Incidental Papilledema Revealing Neurotuberculosis: A Case Report of a Diagnostic Challenge
by Lucia Ambrosio, Serena Panariello, Emanuela Mattiello, Luca D’Andrea, Eugenia Bruzzese, Andrea Lo Vecchio and Mario Damiano Toro
Diagnostics 2026, 16(14), 2199; https://doi.org/10.3390/diagnostics16142199 - 14 Jul 2026
Viewed by 380
Abstract
Background: Tuberculosis (TB) remains a major global health problem, particularly in children, who are at higher risk of extrapulmonary and disseminated disease. Ocular tuberculosis is a rare manifestation and often presents with nonspecific signs, leading to delayed diagnosis. Case Presentation: We [...] Read more.
Background: Tuberculosis (TB) remains a major global health problem, particularly in children, who are at higher risk of extrapulmonary and disseminated disease. Ocular tuberculosis is a rare manifestation and often presents with nonspecific signs, leading to delayed diagnosis. Case Presentation: We report the case of a five-year-old previously healthy boy presenting with a two-month history of persistent fever. Initial investigations revealed a positive tuberculin skin test and interferon gamma release assay, with chest CT findings suggestive of miliary TB. Despite negative microbiological tests, antitubercular therapy was initiated. Ophthalmologic evaluation showed preserved visual acuity, bilateral mild papilledema, and multifocal chorioretinitis. Neuroimaging confirmed central nervous system involvement with disseminated tubercular lesions. Fundus examination revealed grade 1 papilledema and chorioretinal lesions. Ocular ultrasound demonstrated an increased optic nerve sheath diameter consistent with intracranial hypertension. Brain MRI showed intra-axial tubercular dissemination. Extensive infectious and immunological testing excluded alternative diagnoses. The patient received prolonged multidrug antitubercular therapy, including isoniazid, rifampicin, ethambutol, pyrazinamide, amikacin, levofloxacin, and corticosteroids. Treatment was continued for a total of 15 months. Ocular findings regressed within two months, and complete systemic resolution was achieved by 21 months. At a five-year follow-up, the patient remained in good health with normal neurodevelopment and no disease recurrence. Conclusions: This case underscores the importance of considering ocular TB in children with prolonged fever and subtle ocular findings. Early ophthalmologic evaluation and prompt initiation of antitubercular therapy are essential to prevent severe complications and ensure favorable outcomes. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)
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