Cataract surgery in the exciting eye in sympathetic ophthalmia

Abstract

Sympathetic ophthalmia (SO) is a rare, bilateral, non-necrotizing, granulomatous panuveitis that occurs following penetrating injury or a surgical procedure in one eye threatening sight in the fellow eye. Visual prognosis is reasonably good with prompt appropriate wound repair and corticosteroids pre and post-operatively. Only in a severely injured eye with no prognosis for vision is enucleation done within 2 weeks of injury to prevent the disease. We report a case of sympathetic ophthalmia with traumatic cataract following penetrating injury in the exciting eye. Cataract surgery with posterior chamber lens implant was done in the exciting eye, with pre-operative and post-operative cover of steroids, yielding good postoperative vision. If the injured eye has any vision, enucleation should be avoided as this may become the better eye if the fellow eye develops severe inflammation. We present this as a rare case report because after a thorough literature search in Pubmed, to the best of our knowledge, such a case has been rarely reported.