1. Sympathetic ophthalmia
Dr Mamta Agarwal

2. 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

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

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

5. 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)

6. Diagnosis ?? Leptospirosis Tuberculosis Toxoplasmosis
Endogenous endophthalmitis

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

8. After 1 week
Peripapillary atrophy
Subretinal lesions

9. Diagnosis !! Sympathetic ophthalmia Treatment Oral Prednisolone
Azathioprine

10. After 3 months
BCVA /24 N10