2. Sympathetic Uveitis

Sympathetic ophthalmia isa specific bilateral granulomatous inflammation of the uvea usually following surgical or accidental penetrating trauma to the globe. While generally considered rare, its true incidence is difficult to ascertain. One recent report noted an incidence of approximately two cases per 1,000 accidental perforations, and approximately one case per 10,000 intraocular surgical procedures. 1 Another recent clinical review of cases of sympathetic ophthalmia at one center over the past 20 years showed a decrease in the number of such cases following purely accidental or purely surgical injury, and an increase in the number of cases in which accidental injury was followed by surgical intervention in addition to primary repair. 2 Five cases of sympathetic ophthalmia following trauma and vitrectomy have been reported.3 It has been suggested by some that as more attempts at secondary reconstructive surgery (ie, vitrectomy) in severely traumatized eyes are made, a higher incidence of sympathetic uveitis may be expected. 2 However, it is also possible that a single primary or early secondary repair, including vitrectomy or len sectomy if indicated, may be less likely to incite sympathetic ophthalmia than mUltiple secondary procedures. The importance of early removal of lens material after trauma in the prevention of phacoanaphylaxis (phacogenic uveitis) has been stressed. 4 This report presents an additional case of sympathetic ophthalmia following scleral buckling, vitrectomy, and cataract extraction.