Sympathetic Ophthalmitis

Sympathetic Ophthalmitis - this is a rare inflammatory response of the normal eye
following trauma to the other eye. The injured eye is referred to as the "exciting eye",
the undamaged eye as the "sympathizing eye". The aetiology is unknown but the
inflammatory reaction is thought to be the result of autoimmune processes possibly
triggered by the release of uveal pigment from the injured eye. The uveitis in the
sympathising eye may commence at any time after the first fortnight from injury. An
iridocyclitis occurs in both eyes with lacrimation, photophobia, and the presence of
keratic precipitates (K.P.).

Management:
Is primarily prophylactic entailing the removal of a "dangerous eye" when the following
indications are present:
- A badly perforated eye with no vision.
- An injured eye not settling by 14 days, and especially where K.P. are present.
- Sensitivity to light or photophobia developing in the uninjured eye.

If sympathetic ophthalmitis has developed, removal of the exciting eye is too late to
benefit the sympathetic precesses. Sometimes the exciting eye ultimately becomes
the better eye so it is not removed.

Treatment:
Prolonged immunosuppression: systemic corticosteroids or others, atropine eye drops.