Título / Title

SYMPATHETIC OPHTHALMIA AFTER PENETRATING INJURY: A CASE REPORT

Introdução / Purpose

To report a clinical case of a 44-year-old patient presenting with sympathetic ophthalmia one month after penetrating injury in the fellow eye.

Material e Método / Methods

A 44-year-old male patient, with a past medical history of three penetrating keratoplasty procedures to treat corneal ulcer in the left eye (OS), presented at the eye-related emergency department with left corneal perfuration following trauma. He was managed with the application of acyanoacrylate glue corneal patch and topical antibiotic (Fig 1). His visual acuity was 0.2 (logMAR) OD and light perception OS.
One month later, he returned to the emergency department with a four-day history of headache, right eye redness and blurred vision. His visual acuity has decreased to 0.4 (logMAR) OD and remained light perception OS. Examination of OD showed bulbar conjunctival redness, cells in the anterior chamber, hyperemic optic nerve head and exsudative macular detachment with retinal folds (Fig 2).
Spectral-domain optical coherence tomography (SD- OCT) showed a bacillary layer detachment (Fig 3). Fluorescein angiography was also performed and showed late hyperfluorescence by pooling on the macular region., as well as hyperfluorescent perifoveal dots (Fig 4).

Resultados / Results

Based on history, physical examination and ancillary testing, presumptive diagnosis of sympathetic ophthalmia was made and treatment was initiated. Patient was given 1 mg/kg/dia oral prednisone and topical corticosteroids and midryatics. Symptoms improved gradually over the subsequent weeks.

Discussão e Conclusões / Conclusion

It is essential for the ophthalmologist to recognize sympathetic ophthalmia in order to make the right diagnosis and, therefore, the proper treatment.

Palavras Chave

Ophthalmia, Sympathetic

Area

CLINICAL RETINA