A 27-year-old woman was seen in the eye emergency department with a 10-day history of decreased vision and pain in her right eye. The visual acuity measured by the Snellen chart was limited to 20/100 in her right eye. The visual acuity in her left eye was 20/20. Fundus examination showed an elevated nonpigmented mass in the right eye that measured ~2.5x2.5 disc diameters just superior and temporal to the optic disc (green arrows, Figure 1). There was a flat retinal detachment in the macula area, and optical coherence tomography (OCT) showed a choroidal elevated mass (892 microm diameter) associated with a serous retinal detachment (Figure 1). Differential diagnosis included choroidal neoplasia (primary tumor or metastasis), as well as infectious and inflammatory diseases. Malignancy was less likely considering the age of the patient and the presence of ocular pain, however could not be ruled out in the absence of another confirmed etiology. Blood workup showed a negative angiotensin-converting enzyme titer and negative toxoplasma and HIV serologies. The patient was considered to be at a high risk of contracting tuberculosis (TB) and had an unclear history of bacilli Calmette-Guerin vaccination (BCG) vaccination; therefore, she underwent both a QuantiFERON-TB test and a purified protein derivative skin testing. The former was positive and the latter revealed an induration of 13 mm. However, chest X-ray (CXR) was normal. The patient was then addressed to the internal medicine department for further investigations, systemic assessment, and treatment. No pulmonary or systemic involvement was detected. The diagnosis of isolated choroidal tuberculoma was retained and antituberculosis therapy (ATT) was started with daily doses of isoniazid 5 mg/kg, rifampin 10 mg/kg, and pyrazinamide 30 mg/kg, in addition to levofloxacin 750 mg/day as a second-line molecule replacing ethambutol that we wanted to avoid due to its potential of ocular toxicity. This intensive phase lasted 2 months and was followed by a continuation phase of isoniazid and rifampin for at least 4 other months, depending on the response. Visual acuity in the right eye was 20/30 after 3 months of treatment, with a shrinked choroidal tuberculoma (499 microm in diameter) as shown by OCT (Figure 2).