Contributor: Gordon K. Klintworth
Sympathetic ophthalmia (sympathetic uveitis, sympathetic ophthalmitis) is a extremely important preventable bilateral blinding autoimmune disease in which inflammation usually occurs simultaneously in both eyes. It is autoimmune granulomatous uveitis [uveitis - granulomatous] that usually begins at least 5 days after an eye has received a perforating ocular injury or surgery in which uveal tissue becomes incarcerated into the wound. The uninjured sympathizing eye becomes involved later and both eventually both eyes may become blind. Vitiligo and graying of the eyelashes is sometimes associated. The condition is thought to result from an autoimmune response following sensitization to released ocular isoantigens. DalÚn-Fuchs nodule and granulomatous inflammation of the iris, ciliary body, and choroid is characteristic, and the retina is usually spared. Enucleation of an injured eye within 7-14 days of injury usually prevents sympathetic uveitis. Most cases (80%) of sympathetic uveitis develop 3 months after the initial injury but can develop anywhere from 7 days to 50 years. If enucleation of the affected eye is done within 9 days after the inciting event, sympathetic uveitis can be prevented. After 9 days, if the affected eye has no possibility of recovery, enucleation should still be done, as it can aggravate the inflammation in the fellow eye. If the sympathizing eye is severely inflamed, enucleation of the initial eye should not be done, as it may be the better of the two eyes. Sympathetic uveitis may be associated with lens-induced endophthalmitis in cases in which a penetrating injury to the eye interrupts the lens capsule, but also damages uveal tissue.
so damages uveal tissue.