Sympathetic ophthalmia: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
ClaireLewis (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Uveitis of both eyes, following trauma to one eye | *[[Uveitis]] of both eyes, following trauma to one eye | ||
**Due to autoimmune inflammatory response after introduction of immune system to ocular antigens during trauma | **Due to autoimmune inflammatory response after introduction of immune system to ocular antigens during trauma | ||
**Can develop within days to years of initial trauma | **Can develop within days to years of initial trauma | ||
| Line 9: | Line 9: | ||
==Clinical Features== | ==Clinical Features== | ||
*Symptoms | *Symptoms | ||
**Floaters | **[[Floaters]] | ||
**Loss of accommodation | **Loss of accommodation | ||
** | **[[Eye pain]], photophobia | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 24: | Line 24: | ||
==Management== | ==Management== | ||
*Immunosuppressive therapy | *Immunosuppressive therapy | ||
*Mild: | *Mild: [[topical steroids]] and pupillary dilators | ||
*Severe: Systemic steroids, chlorambucil, cyclophosphamide | *Severe: Systemic [[steroids]], chlorambucil, [[cyclophosphamide]] | ||
*Enucleation can reduce symptoms even after the condition has developed | *Enucleation can reduce symptoms even after the condition has developed | ||
Latest revision as of 23:20, 13 November 2016
Background
- Uveitis of both eyes, following trauma to one eye
- Due to autoimmune inflammatory response after introduction of immune system to ocular antigens during trauma
- Can develop within days to years of initial trauma
- Affects 0.03 per 100,000 persons per year
- Prevention
- Because it is so rare, enucleation often not done immediately, if chance of regaining function
Clinical Features
Differential Diagnosis
Acute onset flashers and floaters
- Ocular causes
- Floaters and/or flashes
- Posterior vitreous detachment
- Retinal tear or retinal detachment
- Posterior uveitis
- Predominantly floaters
- Vitreous hemorrhage secondary to proliferative retinopathy
- Sympathetic ophthalmia
- Predominantly flashes
- Oculodigital stimulation
- Rapid eye movements
- Neovascular age-related macular degeneration
- Floaters and/or flashes
- Non-ocular causes
- Intraocular foreign body
- Migraine aura (classic)
- Migraine aura (acephalgicmigraine)
- Occipital lobe disorders
- Postural hypotension
Evaluation
Work-up
Evaluation
Management
- Immunosuppressive therapy
- Mild: topical steroids and pupillary dilators
- Severe: Systemic steroids, chlorambucil, cyclophosphamide
- Enucleation can reduce symptoms even after the condition has developed
Disposition
See Also
External Links
References
- Rosen's Emergency Medicine
- Sympathetic Ophthalmia: https://en.wikipedia.org/wiki/Sympathetic_ophthalmia. Updated on 17 September 2014.