Update on Sympathetic Ophthalmia

Author:

Khan Nida1,Palani Janakiraman2,Biswas Jyotirmay3

Affiliation:

1. Uvea and Medical Retina Fellow, Sankara Nethralaya, Chennai, Tamil Nadu, India

2. Research Optometrist, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India

3. Director of Uveitis and Ocular Pathology, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India

Abstract

Abstract Sympathetic ophthalmia (SO) is a rare bilateral diffuse granulomatous intraocular inflammation, which occurs days or months following surgery or trauma to one eye. After penetrating ocular injuries and during intraocular surgery, the incidence of SO varies from 0.2% to 0.5% and 0.01%, respectively. Other risk factors include cyclodestructive operations and vitreoretinal surgery. With 80% of cases appearing within three months following injury to the exciting eye and 90% occurring within one year, the temporal interval between ocular injury and the onset of SO varies widely, ranging from a few days to decades. The diagnosis is based on clinical findings. It manifests as bilateral diffuse uveitis. In the sympathetic, uninjured eye, patients describe a sneaky beginning of blurred vision, discomfort, epiphora and photophobia. Typically, this is accompanied by conjunctival injection and a granulomatous anterior chamber reaction, resulting in mutton fat keratic precipitates (KPs). The degree of inflammation in the posterior chamber can differ. One of the initial lines of treatment for SO is systemic corticosteroids. Long-term immunomodulatory therapy may involve azathioprine, mycophenolate mofetil, cyclosporine or other immunosuppressive drugs if patients do not respond to steroid therapy or if their side effects are clinically substantial.

Publisher

Medknow

Reference56 articles.

1. Disease of the uveal tract;Duke-Elder;System of Ophthalmology,1966

2. A historical review of sympathetic ophthalmia and its epidemiology;Albert;Surv Ophthalmol,1989

3. 32 cases of sympathetic ophthalmia:A retrospective study at the National Eye Institute, Bethesda, Md, from 1982 to 1992;Chan;Arch Ophthalmol,1995

4. Sympathetic ophthalmia;Castiblanco;Graefes Arch Clin Exp Ophthalmol,2009

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