Title: A Case Report of Sympathetic Ophthalmitis
Authors: Dr Snigdha Gannamraju, Dr Sukitha Sangi, Dr Bala Harshitha Gavicherla, Dr Mahesh Pasham
DOI: https://dx.doi.org/10.18535/jmscr/v10i3.12
Abstract
Introduction
William Mackenzie provided the first full clinical description of the disease coining the term Sympathetic Ophthalmitis(1)
Sympathetic Ophthalmitis is a rare bilateral non necrotising granulomatous uveitis.(2)
This occurs after perforating eye injury or ocular surgical procedure to one eye. The injured eye is exciting eye and the fellow eye developing inflammation days to years later is sympathising eye.
Although rare, Sympathetic Ophthalmitis remains an important public health problem because it can cause bilateral blindness.
Time from injury to onset varies greatly ranging from 1 week to 66 years,(3) within 1 month in 17% cases, within 3months in 50% cases, within 6 months in 65% cases, within first in after injury in 90% cases.
Incidence ranges from 0.2% to 0.5% following injury and 0.01% following intraocular surgery.(4) incidence has reduced in recent years due to meticulous repair of injured eye utilising microsurgical techniques and use of potent steroids.
The reason for naming this disease Sympathetic Ophthalmitis remains obscure. One possible explanation is that the sympathetic pathways (optic nerve and optic chiasma) may be the pathway from the inciting eye to the sympathising eye.(5) Other is the role of immune dysregulation as an etiology. There appears to be cell mediated immune response directed against ocular self antigens found on photoreceptors, RPE or choroidal melanocytes.
No racial or age predisposition. Incidence is equal in male and female after surgery. Disease occurs most frequently in males after trauma. This likely reflects difference in frequency of ocular injury between genders and more often after non surgical trauma(6).
Case Report
A 45 year old female patient came to Ophthalmology OPD with chief complaints of dragging type of pain in left eye since 20days. Diminution of vision for near since 20 days.
No history of trauma to left eye
History of trauma to right eye with stick 10 years ago while working in the fields, since then she developed gradual progressive painless diminution of vision in right eye. No other ocular complaints. No history of usage of glasses. No known systemic illness.
