{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:03:03Z","timestamp":1790103783472,"version":"4.0.1"},"reference-count":9,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,2]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Orbital apex syndrome (OAS) is characterised as dysfunction of the optic nerve, oculomotor nerve, trochlear nerve, abducens nerve and ophthalmic branch of the trigeminal nerve (V1) and has a diversity of aetiologies, including infectious, inflammatory and neoplastic causes. Tuberculosis OAS, a rare manifestation of extrapulmonary tuberculosis, presents a considerable diagnostic challenge because of both its rarity\u2014particularly in non-tuberculosis-endemic countries\u2014and its localisation to this anatomically complex site. In this case report, we present a woman in her mid-60s, living in the midwestern USA, who presented with OAS. Her diagnosis of tuberculosis meningitis was established by dural biopsy demonstrating necrotising granulomas and acid-fast bacilli. After 2 months of modified anti-tuberculosis therapy, she experienced improvement in her extraocular motility and visual acuity.<\/jats:p>","DOI":"10.1136\/bcr-2024-262961","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:15:29Z","timestamp":1790100929000},"page":"e262961","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare ophthalmic complication of tuberculosis meningitis: tuberculosis orbital apex syndrome"],"prefix":"10.1136","volume":"19","author":[{"given":"Wilson X","family":"Wang","sequence":"first","affiliation":[{"name":"Ophthalmology, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary-Grace R","family":"Reeves","sequence":"additional","affiliation":[{"name":"Ophthalmology, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E","family":"Schwetye","sequence":"additional","affiliation":[{"name":"Pathology and Immunology, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3524-2352","authenticated-orcid":false,"given":"Cynthia Lee","family":"Montana","sequence":"additional","affiliation":[{"name":"Ophthalmology, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026092211152129000_19.9.e262961.1","unstructured":"Global tuberculosis report 2022. cc bY-Nc-sa 3.0 iGo. 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Available: https:\/\/www.cdc.gov\/tb\/topic\/treatment\/tbdisease.htm [Accessed 31 Aug 2023]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262961","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:15:30Z","timestamp":1790100930000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262961"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":9,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,22]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2024-262961"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262961","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}