We report a patient who developed BCG endophthalmitis after BCG immunotherapy for bladder cancer. Comparison of this case with 2 other reported cases reveals a similar pattern of elderly, debilitated and immunocompromised patients with poor response to systemic antituberculous therapy in whom systemic steroids are used concurrently. Age and glucocorticoids are known to lead to thymic involution, reduce cell mediated immunity, and a lowering in the number of naive T cells capable of mounting an effective defense to new infectious agents.
Physicians should be aware of the potential for ocular complications of BCG immunotherapy in the elderly, immunocompromised, on oral steroids.