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EIGHTY-TWO-YEAR-OLD MONOCULAR FEMALE WITH ACUTE DECREASED CENTRAL VISION
Monique Munro1, Mohammad Amr Sabbagh, William F Mieler
1Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois.
Retinal Cases & Brief Reports
|February 2, 2023
Summary
This case report details an 82-year-old woman with suspected sympathetic ophthalmia following cataract surgery and enucleation. Early identification and treatment with corticosteroids and immunosuppression were crucial for managing this rare autoimmune condition.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Sympathetic ophthalmia is a rare, bilateral granulomatous inflammation of the uveal tract.
- It classically occurs after intraocular surgery or trauma, but can also follow ocular penetration.
Observation:
- An 82-year-old woman, post-cataract extraction and enucleation due to a complicated course, presented with contralateral choroidal lesions, vitritis, and anterior uveitis.
- Multimodal imaging and systemic work-up suggested an autoimmune etiology for the new ocular findings.
Findings:
- The patient was diagnosed with early sympathetic ophthalmia manifesting as multifocal choroiditis.
- Initial treatment with systemic corticosteroids led to improvement, followed by steroid-sparing immunosuppression for long-term management.
Implications:
- This case highlights the importance of considering sympathetic ophthalmia in elderly patients with a history of ocular surgery, even years later.
- Prompt diagnosis and appropriate immunosuppressive therapy are vital to prevent vision loss in sympathetic ophthalmia.
- Sympathetic ophthalmia can mimic various infectious and non-infectious uveitis conditions, necessitating a thorough diagnostic approach.
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