Sympathetic ophthalmitis with predominant posterior segment involvement

Area of Science:

• Ophthalmology
• Immunology

Background:

• Sympathetic ophthalmitis is a rare, bilateral inflammatory condition affecting the uveal tract.
• Delayed presentation can complicate diagnosis and treatment.

Observation:

• A 22-year-old obese male with intellectual disability sustained a penetrating injury to his left eye.
• The injured left eye became phthisical with no light perception despite primary repair.
• The patient developed anterior uveitis in the right eye, progressing to exudative retinal detachment.

Findings:

• The patient presented with anterior uveitis in the right eye, treated with topical and oral steroids.
• Delayed follow-up revealed exudative retinal detachment, managed with steroids and immunosuppressives.
• Final visual acuity in the affected right eye was 6/60.

Implications:

• This case highlights the importance of consistent follow-up in managing ocular trauma and associated inflammatory conditions.
• Early and aggressive immunosuppressive therapy may be crucial in preventing vision loss in sympathetic ophthalmitis.
• Obesity and intellectual disability may present unique challenges in patient management and adherence to treatment regimens.