In order to determine these pathological manifestations, it is imperative to perform good quality imaging using fluorescein as well as indocyanine green angiography, ultrasonography, optical coherence tomography (especially enhanced-depth imaging), and other such tools. 6 Another interesting aspect of tubercular posterior scleritis is the high rate of positive test results for detection and isolation of acid-fast bacilli albeit from a remote tissue (such as cervical and mediastinal lymph nodes) (one case had positive acid-fast bacilli from an enucleated sample). ...3 out of 5 cases had tissues amenable to biopsy and histopathology and all of them demonstrated mycobacteria conclusively. A learning message from this analysis is that in patients with posterior scleritis with high suspicion of tuberculosis, an aggressive search for acid fast bacilli, or mycobacterial DNA using nucleic acid amplification techniques could prevent misdiagnosis and help in timely initiation of ATT.