The The Challenges in the Management of Sympathetic Ophthalmia: A Case Study

Abstract

Background

Sympathetic ophthalmia is a rare bilateral granulomatous uveitis following ocular trauma or surgery. The first line treatment of sympathetic ophthalmia is aggressive use of corticosteroid therapy. However the relapsing nature of the disease and the adverse reactions patient suffered from high dose corticosteroid therapy are where the challenges lie in managing patient with sympathetic ophthalmia.

Methods

Case report: The patient presented to us with right eye blurring of vision and redness with history of left eye scleral rupture secondary to blunt trauma one month ago. Examination revealed bilateral anterior uveitis with keratic precipitate and multifocal serous retinal detachment on fundus examination. Patient was diagnosed with right eye sympathetic ophthalmia. He was started on high dose corticosteroid therapy. However, immunomodulating agents were also initiated as patient developed steroid induced glaucoma during his treatment. Nonetheless, patient was able to achieve remission with good visual outcome after fine tuning his immunosuppressive therapy.

Conclusion

Symphathetic ophthalmia is a rare bilateral granulomatous uveitis. Hence, it is crucial  to retain an index of suspicion in patient with history of ocular trauma or surgery as well as prompt immunosuppression therapy. A good visual outcome is attainable by fine tuning the balance between the control of ocular inflammation and complication of the immunosuppressive therapy.  

Conflicts of Interest

We declare that there are no conflicts of interest