Abstract
IntroductionSympathetic ophthalmia (SO) is an uncommon bilateral granulomatous panuveitis following uveal trauma to one eye. We present an unusual case of SO which resulted from presumed occult globe rupture following blunt trauma; and highlight the association of trauma and acquired external ocular pigmentation as a possible predictor for SO.Case reportFive weeks following blunt trauma to the left eye (OS), a 30-year-old patient presented complaining of spontaneous blurred vision (4/60) in the right eye (OD). In the OD, there was anterior chamber and vitreous inflammation (3+), multiple areas of serous retinal detachments, Dalen Fuchs spots, and optic disk swelling. In the OS, there was iridodialysis, post-traumatic acquired external ocular pigmentation suggestive of occult globe rupture.This was diagnosed as SO and treated with systemic steroids and a steroid sparing agent; which resulted in resolution of the inflammation with improvement in the visual acuity.ConclusionSympathetic ophthalmia has been reported to occur following penetrating eye injury secondary to trauma and surgery, and also secondary to non-penetrating eye trauma. This case reports SO occurring after presumed occult globe rupture; and reinforces the association between acquired external ocular pigmentation and SO in the context of trauma.
Highlights
Sympathetic ophthalmia (SO) is an uncommon bilateral granulomatous panuveitis following uveal trauma to one eye
Sympathetic ophthalmia has been reported to occur following penetrating eye injury secondary to trauma and surgery, and secondary to non-penetrating eye trauma. This case reports SO occurring after presumed occult globe rupture; and reinforces the association between acquired external ocular pigmentation and SO in the context of trauma
We present an unusual case of SO which resulted from a presumed occult globe rupture following blunt trauma; and highlight the fact that acquired external ocular pigmentation in association with trauma can be a possible predictor for SO
Summary
The temporal association between the injury sustained to the left eye and resultant bilateral intraocular inflammation would suggest trauma as the precipitant factor. We suggest that SO is the pathogenic process in this patient. SO has been reported to occur following penetrating eye injury, non-penetrating eye trauma [6], and following intraocular surgery especially vitreoretinal [5]. This case demonstrates that it is likely that SO can occur following occult globe rupture as well; and highlights the fact that acquired external ocular pigmentation in association with trauma can be a possible predictor for SO
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