E-POSTER DETAIL | 11th Asia Pacific Tele Ophthalmology Society Symposium

Title
COLLATERAL DAMAGE: A Case Report on Sympathetic Ophthalmia in a 35-Year-Old Female Filipino Patient

Authors
PIA JEJAME MAMARIL-BALAJO, JANICE FERRER-BERNARDO, ANGELIQUE CHIU-ANG

Presenting
PIA JEJAME MAMARIL-BALAJO

PURPOSE:
Sympathetic ophthalmia is a rare autoimmune ocular inflammatory, with an incidence of approximately 0.03 per 100,000 persons per year. This case report details the progression, diagnosis, and management of SO, specifically analyzing the sequential blurring of vision in the fellow eye.

METHODS:
A 35-year-old Filipino female initially presented with a one- month history of bilateral sequential progressive painless blurring in the left eye, following a prior traumatic injury on the right eye. Initial ophthalmic examination revealed poor light projection and an intraocular pressure of 8 mmHg in OD, along with a supraorbital scar, enophthalmos, and Grade I traumatic hyphema. Visual acuity in OS was counting fingers, best corrected to 20/200, with granulomatous keratic precipitates, an IOP of 12 mmHg and optic nerve swelling. Despite multiple consultations and an initial impression of non-penetrating globe injury with intraocular hemorrhage on OD and optic disc edema on OS.

METHODS:

A 35-year-old Filipino female initially presented with a one- month history of bilateral sequential progressive painless blurring in the left eye, following a prior traumatic injury on the right eye. Initial ophthalmic examination revealed poor light projection and an intraocular pressure of 8 mmHg in OD, along with a supraorbital scar, enophthalmos, and Grade I traumatic hyphema. Visual acuity in OS was counting fingers, best corrected to 20/200, with granulomatous keratic precipitates, an IOP of 12 mmHg and optic nerve swelling. Despite multiple consultations and an initial impression of non-penetrating globe injury with intraocular hemorrhage on OD and optic disc edema on OS.

RESULTS:
Further diagnostic workup- including an orbital MRI with contrast- led to the final diagnosis of a ruptured right globe, and Sympathetic Ophthalmia in OS. Early enucleation of the injured OD was performed, a measure known to improve the visual prognosis of the fellow eye. Also, following treatment with high-dose intravenous steroids and immunosuppressive therapy, vision in OS improved to 20/20.

CONCLUSIONS:
The incidence of SO following traumatic eye injury is approximately 0.19%. Management requires prompt hospitalization, administration of high-dose corticosteroids, and Immunosuppressive therapy, which are key to improving visual outcomes in affected patients.