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Incidence and Risk Factors for Sympathetic Ophthalmia Following Open Globe Injuries: A Population-Based Analysis.

Niloufar Bineshfar1, Natalia Davila2, Chloe Shields1

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|November 20, 2025
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Summary
This summary is machine-generated.

Sympathetic ophthalmia (SO) after open globe injuries (OGIs) is rare but a long-term risk. Early eye removal surgery did not significantly reduce SO risk, but certain ethnicities face higher risks.

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Area of Science:

  • Ophthalmology
  • Trauma Surgery
  • Public Health

Background:

  • Sympathetic ophthalmia (SO) is a rare but serious condition that can occur after open globe injuries (OGIs).
  • Understanding the incidence, risk factors, and potential preventative measures for SO is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence and risk factors for SO following OGIs.
  • To evaluate the effectiveness of early eye removal surgeries (enucleation/evisceration) in preventing SO.
  • To identify demographic factors associated with increased SO risk.

Main Methods:

  • Retrospective clinical cohort study using de-identified data from the TriNetX network.
  • Analysis of 63,763 patients diagnosed with OGIs between September 2004 and September 2024.
  • Calculation of SO incidence rates at 6 months, 1, 5, and 10 years post-injury using Cox proportional hazard models.

Main Results:

  • Overall SO incidence was 0.13% at 6 months and 0.18% at 10 years post-OGI.
  • Most SO cases (74.3%) presented within 6 months of injury.
  • Early eye removal within 30 days showed a non-significant trend towards lower SO risk (HR 0.655, P=.416).
  • Increased SO risk was associated with Native Hawaiian/Other Pacific Islander (HR: 6.775) and Hispanic (HR: 2.862) ethnicities.

Conclusions:

  • Sympathetic ophthalmia is a rare but persistent risk following open globe injuries, primarily manifesting within the first year.
  • Early eye removal surgery within 30 days did not demonstrate a statistically significant protective effect against SO.
  • Targeted surveillance and follow-up are recommended for individuals of Native Hawaiian/Other Pacific Islander and Hispanic ethnicities due to their elevated risk of SO.