Sympathetic ophthalmia

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Background

  • Uveitis of both eyes, following trauma to one eye
    • Due to autoimmune inflammatory response after introduction of immune system to ocular antigens during trauma
    • Can develop within days to years of initial trauma
    • Affects 0.03 per 100,000 persons per year
  • Prevention
    • Because it is so rare, enucleation often not done immediately, if chance of regaining function

Clinical Features

Differential Diagnosis

Acute onset flashers and floaters

  • Ocular causes
  • Nonocular causes
    • Migraine aura (classic)
    • Migraine aura (acephalgicmigraine)
    • Occipital lobe disorders
    • Postural hypotension

Evaluation

Work-up

Evaluation

Management

  • Immunosuppressive therapy
  • Mild: topical steroids and pupillary dilators
  • Severe: Systemic steroids, chlorambucil, cyclophosphamide
  • Enucleation can reduce symptoms even after the condition has developed

Disposition

See Also

External Links

References