Sympathetic ophthalmia is inflammation of the uveal tract after trauma or surgery to the other eye.
Sympathetic ophthalmia is a rare granulomatous uveitis that occurs after penetrating trauma or surgery to the other eye. Sympathetic ophthalmia has been estimated to occur in between 0.2 and 0.5% of people following penetrating eye wounds and in about 0.1% of patients after intraocular surgery (1). The underlying mechanism is thought to be an autoimmune reaction directed against melanin-containing cells in the uvea. This is the same mechanism suspected in Vogt-Koyanagi-Harada disease. Uveitis appears within 2 to 12 weeks after trauma or surgery in most cases. Isolated cases of sympathetic ophthalmia can occur as early as 1 week or as late as 30 years after the initial trauma or surgery.
Symptoms of the granulomatous uveitis can involve any or all segments of the eye. Symptoms typically include floaters and decreased vision. Serous detachments and choroiditis are common.
Diagnosis is clinical.
(See also Overview of Uveitis.)
Reference
1. Marak GE, Jr: Recent advances in sympathetic ophthalmia. Surv Ophthalmol 24(3):141-156, 1979. doi: 10.1016/0039-6257(79)90018-3
Treatment of Sympathetic Ophthalmia
Oral corticosteroids and other immunosuppressants
With severe injuries, possibly early prophylactic enucleation
Treatment reference
1. Agarwal M, Radosavljevic A, Tyagi M, et al: Sympathetic ophthalmia — An overview. Ocul Immunol Inflamm 31(4):793-809, 2023. doi: 10.1080/09273948.2022.2058554
