Ocular tuberculosis (OTB) remains a presumptive clinical diagnosis, based on indicative ophthalmic features and prior exposure to TB. Ocular sampling is unhelpful, so the diagnosis is supported by evidence of subclinical TB remote to the eye and response to anti-tuberculous therapy (ATT). We test the hypothesis that FDG-PET CT imaging might be useful in OTB patients, most of whom describe visual symptoms as the presenting feature of TB, without respiratory or constitutional symptoms. Patients were identified by analysing referrals between a tertiary referral centre for ophthalmology and its regional TB service, over a five year period, with data collection continuing prospectively. Additional cases were identified from our region’s TB Register, where the eye(s) had been recorded as an extra-pulmonary site of TB. As part of TB screening, all patients had a chest X-ray (CXR) and interferon gamma release assay (with or without Tuberculin Skin Test). The TB medical team then assessed whether thoracic CT was indicated, to identify lymphadenopathy for endobronchial sampling, or an FDG-PET scan to look for avid thoracic or extra-thoracic lymph nodes. In 40 patients, CXRs were essentially normal in two thirds and reported as abnormal, but not indicative of pulmonary TB, in one third. Thoracic CT in 15 patients demonstrated abnormal features in 8, half of whom went on to have endobronchial sampling. FDG-PET scans in 18 patients demonstrated avid nodes in 12: thoracic in 8 and extra-thoracic in 7 (cervical, axillary, pancreatic and inguinal). Overall, FDG-PET directed additional endobronchial sampling in 4 patients without enlarged thoracic nodes on conventional CT and ultrasound-guided biopsy of extra-thoracic sites in 7 patients, 2 of which subsequently demonstrated TB in culture. We describe a highly phenotyped cohort of OTB patients. There are currently no published series utilising FDG-PET CT scanning as a routine part of the investigation strategy in this condition. Whilst OTB treatment remains empirical in many cases, our preliminary Results indicate that FDG-PET is a useful imaging modality for some patients and has a potential additional yield in subclinical TB over thoracic CT imaging, allowing activity to be detected in normal-sized thoracic nodes and also extra-thoracic sites.