An Atypical Presentation of Sympathetic Ophthalmia in an Intact Globe Following Mechanical Fall: A Case Report and Literature Review

Chean, Chung Shen; Lim, Christina S; Kumar, Periyasamy; Kapoor, Bharat

doi:10.3390/vision5010011

Cited by 4 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 In such case, recent trauma, even if non-invasive, may have favored the onset of SO, as observed in other studies. 10,11 To the best of our knowledge, only two cases of SO have been described in the literature in which SB was the only apparent risk factor. Parvesh et al 12 described a case of SO in a young woman who underwent a buckle revision with SRFD and cryoretinopexy 4 years after the primary surgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Presumed sympathetic ophthalmia following scleral buckling surgery: A case report and review of the literature

Lucchini

Govetto

Carini

et al. 2022

European Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To report a case of presumed sympathetic ophthalmia (SO) following scleral buckling (SB) surgery and to discuss the possible pathogenesis of this condition by reviewing the current evidence on this subject. Methods Case report and narrative review of the literature; our case was imaged with spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA), fundus autofluorescence (FAF), fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Results A 55-year-old man presented with a macula on rhegmatogenous retinal detachment which was treated with 360° SB surgery, subretinal fluid drain (SRFD), cryopexy and pneumoretinopexy. Due to failure of the primary surgery, a second procedure was performed the day after with the explant of the prior buckle and the implant of a wider circumferential element. At three months from surgery, the patient complained of severe bilateral vision loss. Multimodal imaging revealed bilateral, multi-focal exudative retinal detachments and choroidal swelling. A diagnosis of presumed SO was made and the patient was treated with a combination of steroid and immunosuppressive drugs. The clinical picture completely resolved at postoperative month 12. Conclusion SO may be a rare complication of SB surgery. In our case, early recognition and prompt immunosuppressive treatment achieved good long-term clinical results.

show abstract

Section: Discussionmentioning

confidence: 99%

“…9 In such case, recent trauma, even if non-invasive, may have favored the onset of SO, as observed in other studies. 10,11…”

Section: Discussionmentioning

confidence: 99%

Presumed sympathetic ophthalmia following scleral buckling surgery: A case report and review of the literature

Lucchini

Govetto

Carini

et al. 2022

European Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…[ 13 ] The development of SO in the absence of preceding penetrating trauma or surgery is very rare. [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

An atypical presentation of sympathetic ophthalmia following chemical ocular burns

Bansal

Singh

Gupta

et al. 2023

J Ophthal Inflamm Infect

View full text Add to dashboard Cite

Background Sympathetic ophthalmia is a rare disease that can present as bilateral granulomatous uveitis after a penetrating trauma or surgery in one eye. Findings We report a case of a 47-year-old male with history of decreased vision in the right eye, six months after sustaining severe chemical injury in the left eye. He was diagnosed with sympathetic ophthalmia and was treated with corticosteroids and long-term immunosuppressive therapy, leading to complete resolution of intraocular inflammation. Final visual acuity was 20/30 at one year of follow up. Conclusions Sympathetic Ophthalmia following chemical ocular burns is extremely uncommon. It can present as a diagnostic and therapeutic challenge. It warrants early diagnosis and management.

show abstract

“…5,15,[71][72][73][74][75][76][77][78][79][80][81][82][83] Nonpenetrating blunt trauma and severe ocular burns have also been reported to be associated with SO. [84][85][86][87] A case was even reported of SO following panuveitis from a wasp sting to the inciting eye. 88…”

Section: Sympathetic Ophthalmiamentioning

confidence: 99%

The Ruptured Globe, Sympathetic Ophthalmia, and the 14-Day Rule

Jordan

Dutton

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose: Prophylactic enucleation of a ruptured globe with no light perception within 14 days of injury to prevent sympathetic ophthalmia (SO) has been an established dictum in academic teaching for more than 100 years. This treatment strategy was originally based on observation, speculation, and careful thought, but there was never any scientific proof. This review summarizes and updates the current state of our knowledge about globe rupture and SO, examines the origin and validity of the 14-day rule, and emphasizes the importance of trying to save the traumatized eye whenever possible.Methods: A comprehensive literature review of SO and globe rupture was performed.Results: SO is a rare disorder that may potentially occur following traumatic globe rupture as well as following a variety of other intraocular surgeries. Vitreoretinal surgery may be a more common cause than trauma according to some studies. SO may still occur despite having the eye removed within 14 days of the trauma. A variety of new medications including biologic agents are now available to treat SO with improved efficacy in suppressing the associated ocular inflammation and allowing retention of some useful vision. Removing the traumatized, blind eye may have other important psychological consequences associated with it that require consideration before eye removal is carried out. Retaining the blind, phthisical, disfigured eye avoids phantom vision and phantom pain associated with enucleation as well as providing a good platform to support and move an overlying prosthetic eye. Data on the occurrence of SO following evisceration and enucleation with and without predisposing factors confirms the exceedingly low risk. Conclusion:Most civilian open globe injuries can be successfully repaired with modern, advanced microsurgical techniques currently available. Because of the exceedingly low risk of SO, even with the severity of open globe trauma during military conflicts being more devastating as a result of the blast and explosive injuries, today every attempt is made to primarily close the eye rather than primarily enucleate it, providing there is enough viable tissue to repair. The 14-day rule for eye removal after severe globe ruptures is not scientifically supported and does not always protect against SO, but the safe time period for prophylactic eye removal is not definitively known. In the exceptional cases where SO does occur, several new medications are now available that may help treat SO. We advocate saving the ruptured globe whenever possible and avoiding prophylactic enucleation to prevent the rare occurrence of SO. When an eye requires removal, evisceration is an acceptable alternative to enucleation in cases that do not harbor intraocular malignancy.

show abstract

An Atypical Presentation of Sympathetic Ophthalmia in an Intact Globe Following Mechanical Fall: A Case Report and Literature Review

Cited by 4 publications

References 21 publications

Presumed sympathetic ophthalmia following scleral buckling surgery: A case report and review of the literature

Presumed sympathetic ophthalmia following scleral buckling surgery: A case report and review of the literature

An atypical presentation of sympathetic ophthalmia following chemical ocular burns

The Ruptured Globe, Sympathetic Ophthalmia, and the 14-Day Rule

Contact Info

Product

Resources

About