ICD 10 CM A18.59 | Description & Clinical Information
ICD 10 A18.59 describes a unique and infrequent occurrence of extrapulmonary tuberculosis caused by the reactivation of Mycobacterium tuberculosis or, in rare cases, Mycobacterium bovis, or through direct introduction of the bacteria via an open wound, resulting in tuberculosis of the eye that presents with symptoms not represented by any other code.
Official Description Of A18.59
The ICD 10 CM book defines ICD 10 code A18.59 as:
Excludes2: lupus vulgaris of eyelid (A18.4)
When To Use A18.59
The diagnosis describes by the ICD 10 CM A18.59 code pertains to tuberculosis (TB) of the eye. This condition can cause a range of symptoms, including abscess or inflammation of external structures of the eye such as the lid (blepharitis), conjunctiva (conjunctivitis), interstitial keratitis, and/or sclera (scleritis). Additionally, granulomatous masses that involve the sebaceous (oil) glands inside the lid can occur, which is called an atypical chalazion. Some patients may experience discharge of mucus and pus.
TB can also affect the eye in more serious ways, causing intraocular manifestations such as inflammation of the uvea, iris, and ciliary body (iridocyclitis), and the choroid and retina (retinochoroiditis). Granulomatous changes within the iris, cornea, choroid, and even the optic nerve can also take place. All these symptoms can be severe and cause significant discomfort and pain.
Diagnosis of ocular TB is challenging and often inconclusive. Providers may diagnose the condition based on PCR of blood serum and/or intraocular fluid, a tuberculin skin test, and the patient’s prior history of tuberculosis or active disease. While ocular imaging studies, such as fluorescein or indocyanine green angiography, ocular coherence tomography (OCT), and ocular ultrasound, or biomicroscopy, which is a combined slit-lamp and microscopic examination, are of little use in the primary diagnosis of TB, they may be useful in diagnosing uveitis complications.
Treatment of TB of the eye requires antituberculous chemotherapy, which usually involves a combination of isoniazid, rifampin, rifabutin, pyrazinamide, and ethambutol, to be effective. Providers may also employ topical, periocular, intraocular, and systemic steroids to treat inflammation and relieve associated symptoms.
It is important to note that, as with any medical condition, early detection and treatment are key to preventing long-term damage to the eye and preserving vision. Therefore, if you experience any unusual symptoms of the eye, such as redness, pain, or discharge, seek medical attention as soon as possible.
