Full-size Left-side Hidden
Chapter 81 – Sympathetic ophthalmia

Mirunalini Kumaradas,
Narsing A Rao

Clinical background

Sympathetic ophthalmia (SO) is a rare intraocular inflammation that presents as a bilateral diffuse granulomatous uveitis following penetrating trauma or ocular surgery involving one eye. Following trauma to one globe (the exciting eye), intraocular inflammation develops in the fellow eye (the sympathizing eye) after a variable period of time ranging from a few days to decades. Although the pathophysiology of this disease is not clearly understood, an autoimmune process against peptides of melanocytes has been proposed. In 1830 Mackenzie gave a detailed clinical description of SO,[1] and Fuchs established the pathological features of this disease in 1905.[2]

SO is a potentially devastating disease with many exacerbations, and long-term follow-up is essential. A high index of suspicion, early diagnosis, advances in surgical procedures, and the use of immunomodulatory agents have improved the visual outcome of …