Sympathetic ophthalmia: Difference between revisions
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Revision as of 21:47, 25 July 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
- Symptoms
- Floaters
- Loss of accommodation
- Pain, photophobia
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: local corticosteroids 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.