Phlyctenular keratoconjunctivitis is a rare manifestation of tuberculosis. If the disease is acute, local corticosteroid therapy coupled with systemic antituberculous drugs commonly results in a speedy cure. However, in chronic or recurrent disease, therapy is less effective. In such cases, antituberculous drugs alone are usually ineffectual, and supplementation with topical corticosteroids may have only a temporary suppressive effect.
It is generally believed that the phlyctenules of phlyctenular keratoconjunctivitis represent mainly an allergic response to tuberculoprotein.1 Desensitization treatment with tuberculin has been used successfully for adjunctive therapy in certain carefully selected cases in which the usual agents, such as topical steroids and systemic antibiotics, were ineffective.2,3 Pines3 has reported that systemic corticosteroid therapy facilitates rapid desensitization with tuberculin.
Since no experimental evidence has been gained in animals or in man that tuberculin treatment sufficient to effectively abolish skin reactivity will at the same time abolish corneal reactivity, the
MILNER JE, WEISER RS. The Corneal Tuberculin ReactionEffect of Systemic Desensitization Treatment. Arch Ophthalmol. 1965;74(6):845-846. doi:10.1001/archopht.1965.00970040847022