A 20 year old man complains of difficulty in reading the newspaper with his right eye, three weeks after sustaining a gun shot injury to his left eye. Which of the following is the most likely diagnosis?
Correct Answer: Sympathetic ophthalmia
Description: This man in the question has developed a condition called sympathetic ophthalmia in the right eye secondary to the injury in the left eye. Sympathetic ophthalmia is an inflammation in the second eye after the other has been damaged by penetrating injury. Some poion of the uvea of the injured eye has been exposed to the atmosphere for at least 1 hour. The uninjured eye develops minor signs of anterior uveitis usually within 1 year. Due to the inflammation of ciliary body, patients initially presents with floating spots and loss of the power of accommodation. The disease may progress to severe iridocyclitis with pain and photophobia. The retina is usually uninvolved except for perivascular cuffing of the retinal vessels with inflammatory cells. Optic nerve swelling and secondary glaucoma may occur. The best prophylaxis is early excision of the injured eye, when there is no chance of saving useful vision. Ref: Comprehensive Ophthalmology By AK Khurana, 4th Edition, Page 273; Vaughan and Asbury's General Ophthalmology, 18th Edition, Chapter 16.
Category:
Ophthalmology
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