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Sympathetic Ophthalmia Following an Evisceration Surgery-A Case Report.

Rahmah Javed1, Saba Al-Khairy1, Hamna Khan1

  • 1Dow Medical College Dow University of Health Sciences Karachi Pakistan.

Clinical Case Reports
|November 29, 2024
PubMed
Summary

Sympathetic ophthalmia (SO) is a rare condition that can occur after eye surgery. This case highlights successful treatment with methotrexate for SO following evisceration surgery.

Keywords:
case reporteviscerationpanuveitisraresympathetic ophthalmia

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Area of Science:

  • Ophthalmology
  • Immunology

Background:

  • Sympathetic ophthalmia (SO) is a rare, bilateral, granulomatous panuveitis.
  • It typically follows ocular trauma or surgery.
  • SO can lead to significant vision loss if not promptly managed.

Purpose of the Study:

  • To report the first case of sympathetic ophthalmia following evisceration surgery in Pakistan.
  • To highlight the diagnostic challenges and treatment outcomes for SO in this context.

Main Methods:

  • Clinical presentation and slit lamp examination were used for diagnosis.
  • The patient was initially treated with high-dose corticosteroids.
  • Methotrexate was subsequently prescribed due to non-response to corticosteroids.

Main Results:

  • The patient presented with symptoms of SO in the sympathizing eye one week after evisceration.
  • Clinical findings included mutton fat keratic precipitates, posterior synechiae, and optic disc swelling.
  • Methotrexate treatment effectively resolved inflammation and improved visual acuity, unlike initial corticosteroid therapy.

Conclusions:

  • Evisceration surgery can be a precipitating factor for sympathetic ophthalmia.
  • Methotrexate is an effective treatment option for sympathetic ophthalmia, particularly in cases resistant to corticosteroids.
  • Prompt diagnosis and treatment are crucial to prevent vision loss in sympathetic ophthalmia.