A clinical case of an ophthalmological presentation of a combined infection with Mycobacteria tuberculosis and bovis is presented. The case was characterized by several challenges, both on a diagnostic and also on a therapeutic level in a multimorbid patient with chronic lung disease and bladder carcinoma. The latter thereby was identified as the indirect source of the M. bovis infection, which was the result of a spill over of BCG instillation used to treat the bladder cancer.