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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 up to 0.5% of nonsurgical and in < 0.1% of surgical penetrating eye wounds. The underlying mechanism is thought to be an autoimmune reaction directed against melanin-containing cells in the uvea. Uveitis appears within 2 to 12 wk after injury in about 80% of cases. Isolated cases of sympathetic ophthalmia have occurred as early as 1 wk or as late as 30 yr after the initial injury or surgery.
Symptoms typically include floaters and decreased vision. Choroiditis, often with overlying exudative retinal detachment, is common.
Treatment typically requires oral corticosteroids plus a long-term noncorticosteroid immunosuppressive drug. Prophylactic enucleation of a severely injured eye should be considered within 2 wk of vision loss to minimize the risk of sympathetic ophthalmia developing in the other eye, but only when the injured eye has no vision potential.
Last full review/revision July 2008 by Emmett T. Cunningham, Jr., MD, PhD, MPH
Content last modified July 2008
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