To report the clinical profile and management of orbital tuberculosis (TB) in children.

Eight cases were studied retrospectively.

Ages in the range of 3–16 years. Three cases presented with discharging sinus in upper lid, three with a cystic mass and two with lid necrosis. Underlying bony changes were found in five patients. Drainage and curettage was done for five patients, needle drainage of fluid was done in one patient and in two patients local debridement was done. Polymerase chain reaction for tuberculosis was positive in four cases and acid fast bacilli (AFB) were isolated on culture in three cases. On histopathology, six cases had granulomatous inflammation with caseating necrosis in one, though AFB could not be found. A favourable response to anti-tubercular treatment was achieved in all cases.

High index of suspicion is required for diagnosis of orbital TB. Microbiological and pathological diagnosis may not be achieved in all cases.