Sympathetic ophthalmia

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Presentation transcript:

Sympathetic ophthalmia Dr Mamta Agarwal

History 28 yr old farmer OD C/O decreased vision & pain x 2 months OS Phthisical eye following infection x 25 yrs No systemic illness

Clinical findings BCVA OD 2/60 OS NPL EOM full SLE OD - AC cells ++, flare + Vitreous cells ++

Multiple yellowish white fluffy sub retinal lesions, vitreitis Fundus Multiple yellowish white fluffy sub retinal lesions, vitreitis

Investigations TLC, DLC, ESR NORMAL ELISA HIV, Toxo -ve VDRL / TPHA non reactive ELISA Leptospira IgM +ve 13U (>11U) Aqueous tap PCR -ve (M. TB, Eubacterial genome)

Diagnosis ?? Leptospirosis Tuberculosis Toxoplasmosis Endogenous endophthalmitis

Treatment Therapeutic vitrectomy Tab Ciplox 500 mg BD Tab Prednisolone 60mg/day Topical steroids & cycloplegics Vitreous aspirate No bacteria / fungus

After 1 week Peripapillary atrophy Subretinal lesions

Diagnosis !! Sympathetic ophthalmia Treatment Oral Prednisolone Azathioprine

After 3 months BCVA 6/24 N10