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Sympathetic ophthalmia
Last reviewed: 07.07.2025
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Sympathetic ophthalmia is an extremely rare, bilateral granulomatous panuveitis that develops after penetrating trauma complicated by choroidal prolapse, or after intraocular surgeries (less common). The injured eye is called sympathetic, and the healthy eye, in which uveitis also develops, is called sympathetic.
Sympathetic ophthalmia occurs in 65% of cases - from 2 weeks to 3 months after the primary injury; in 90% of cases - within the first year.
[ Symptoms of sympathetic ophthalmia
- The sympathetic eye shows signs of primary injury and is often hyperemic and irritated.
- The sympathetic eye is characterized by photophobia and irritation.
- Then, chronic granulomatous anterior uveitis with nodules on the iris and fatty precipitates on the cornea develops in both eyes.
- Edema of the optic disc and multifocal choroiditis develop throughout the fundus.
The course of sympathetic ophthalmia
Rarely uveitis occurs in a mild form but as a self-limiting process. Usually, intraocular inflammation is chronic and, in the absence of adequate treatment, leads to the development of cataracts, glaucoma and death of the eye.
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Treatment of sympathetic ophthalmia
Treatment of sympathetic ophthalmia with systemic steroids is usually effective and the long-term prognosis for vision is good. Immunosuppressive agents are also indicated and help reduce the steroid dose.