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Case Report

An Atypical Case of Sympathetic Ophthalmia Following Zone 1 Corneal Injury

Praveen Subudhi* , Praveen Subudhi* , B.N.R. Subudhi**

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Ophthalmology and Allied Sciences 2(1):p 27-30, Jan-Jun 2016. | DOI: DOI: http://dx.doi.org/10.21088/oas.2454.7816.2116.6

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Abstract

 Purpose: To report a case of atypical sympathetic ophthalmia following limbal corneal laceration. Methods and Results: An eleven year oldchild had a successful left eye (OS) corneal laceration repair at the temporal limbus with excision of exposed non necrotic iris tissue, resulting in good visual acuity of 20/ 80 and 20/25 postoperative day 1 and 7 respectively. The patient was prescribed 1mg/kg oral prednisolonein a tapering dose as prophylaxis. Post operative day 21, patient presented with acute onset decreased vision in both eyes. Visual acuity was counting fingers 3 feet in both eyes. On examination, anterior segment examination was quiet without any inflammation, anterior vitreous face showed 1+ cells and dilatedfundoscopy revealed bilateral symmetrical serous retinal detachmentsalongthe posterior pole. Optical coherence tomography (OCT)demonstrated separation and elevation of inner neurosensory layers from the outer segment marking presence of hyperreflective material along with subretinal fluid between detached surfaces. There was stippled hyperfluorescence along theposterior pole as seen in fluorescein angiography. With a diagnosis of sympathetic ophthalmia confirmed, oral prednisolne (2 mg/kg body weight) was instituted following which, there was gradual decrease in macular elevation with corresponding improvement in visual acuity with no recurrence for last 6 months. Conclusion: To our knowledge, this is the first reported instance of an atypical presentation of sympathetic ophthalmia and antecedant corticosteroid therapy would have mitigated robust anterior segment findings usually associated with the condition.

Keywords: Corneal Laceration; OCT; Open Globe Injury; Exudative Macular Elevation; Uveal Prolapse.

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DOI: DOI: http://dx.doi.org/10.21088/oas.2454.7816.2116.6

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