Sympathetic Ophthalmia After Complicated Cataract Surgery.

Background: Sympathetic ophthalmia (SO) is a bilateral, diffuse granulomatous panuveitis that can occur after a penetrating trauma or intraocular surgery. The time from ocular injury to the onset of sympathetic ophthalmia varies greatly, ranging from several days to decades.

Objective: We report on the diagnostic dilemma and clinical outcome of patient with sympathetic ophthalmia within 2 weeks of cataract surgery.

Case presentation: A patient underwent left eye cataract surgery that was complicated by postoperative iris prolapse through the corneal wound. The wound was sutures with iris still entrapped, and he presented to our clinic 1 week later with bilateral vision loss and panuveitis. After workup for other inflammatory or infectious causes, sympathetic ophthalmia was diagnosed, and the patient was treated with topical and systemic corticosteroids. One month later, visual acuity improved markedly in both eyes, and inflammatory symptoms and findings resolved. Sympathetic ophthalmia may occur soon after cataract surgery and can be confused with infectious endophthalmitis, which must be considered.

Conclusion: Prompt diagnosis and institution of corticosteroid therapy is essential and may result in significant visual improvement in both eyes.