What are
the symptoms of sympathetic ophthalmia (SO)?
The symptoms of sympathetic ophthalmia include:
bilateral eye pain, photophobia, decreased vision (near vision is often
affected before distance vision), red eye. A history of penetrating
trauma or intraocular surgery to one eye (usually 4 to 8 weeks before,
but the range is from 5 days to 66 years, with 90% occurring within 1
year) may be elicited.
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What are the critical signs?
Any inflammation in the uninvolved eye after
unilateral ocular trauma is suspicious. Your ophthalmologist will see
bilateral severe anterior-chamber reaction with large mutton-fat keratic
precipitates, small depigmented nodules at the level of the retinal
pigment epithelium (Dalen-Fuchs' nodules), and thickening of the uveal
tract. Signs of previous injury or surgery in one eye are usually
present, including indications of previous laser therapy or cryotherapy.
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What are the differentials?
Sympathetic ophthalmia may be mistaken for VOgt-Koyanagi-Harada
syndrome (VKH), phacoanaphylactic endophthalmitis, sarcoidosis, and
syphilis.
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What are the useful workups?
History may reveal a prior eye surgery or injury. The
presence of venereal disease and difficulty of breathing may be helpful.
A complete ophthalmic examination including a dilated retinal
examination should be performed. Blood extraction for the following:
complete blood count (CBC), rapid plasma reagin (RPR), FTA-ABS, with or
without angiotension converting enzyme (ACE) level if sarcoidosis is a
serious consideration. A chest radiograph may be requested to evaluate
for tuberculosis or sarcoidosis. A flourescein angiography or B-scan
ultrasonography or both may help in confirming the diagnosis.
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How do you treat SO?
The best way to treat SO is to prevent it. The
enucleation of a blind, traumatized eye before a sympathetic reaction
can develop (usually within 7 to 14 days of the trauma). If sympathetic
ophthalmia develops, enucleation may still be beneficial, regardless of
the time since the trauma.
Inflammation is controlled with steroids; the dose
depends on the severity of the inflammation. In moderate to severe
cases, the following regimen can be used initially. Steroids are tapered
slowly as the condition improves. A combination of topical, periocular,
systemic steroids are usually necessary. Topical cycloplegic agents are
also used. If steroids are ineffective or contraindicated, an
immunosuppressive agent may be tried.
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How should one be followed
up?
Patients with SO are followed up every 1 to 7 days
initially, to monitor the effectiveness of therapy. As the condition
improves, the follow-up interval may be extended to every 3 to 4 weeks.
Intraocular pressure must be monitored closely. Steroids should be
maintained for 3 to 6 months after all signs of inflammation have
resolved. Because of the possibility of recurrence, periodic checkups
are essential.
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How
do I get more information?
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
Hover note: Please place your mouse cursor over the red box
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ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
http://www.LASIK.com.ph - Refractive
Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
EMAIL. After writing down your comments,
suggestions, problems and/or questions, kindly tell us how
to get in touch with you by providing your name, email,
home/office numbers, and mobile phone.
General inquiries - help@EyeRepublic.com.ph
Refractive Surgery Service - refractive.surgery@EyeRepublic.com.ph
Glaucoma Service - glaucoma@EyeRepublic.com.ph
Cataract Service - cataract@EyeRepublic.com.ph
Doctors - eyemd@EyeRepublic.com.ph
Administrative - president@EyeRepublic.com.ph
Website - webmaster@EyeRepublic.com.ph
Newsletter -
newsletter@EyeRepublic.com.ph (receive
news and updates, discounts and promotions)
BLOG. Send us your comments.
EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
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CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
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