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The unusual ocular type of tuberculosis (TB), known as choroidal tuberculoma, poses diagnostic and treatment challenges, particularly when it occurs in the absence of other disease signs. Patients with ocular tuberculosis have choroidal tuberculomas. They rarely present as the first sign of tuberculosis without any prior systemic symptoms, and they typically occur in patients who have had the disease in the past. We present a 13 year old Boy with unilateral choroidal tuberculoma with meningitis as the primary sign of presumptive ocular tuberculosis allowed for early therapy to be started.