Sympathetic
ophthalmia or sympathetic uveitis is an inflammatory condition seen after
severe perforating or penetrating ocular injury, usually associated with
loss of uveal tissue or uveal prolapse.This condition is characterized by a diffuse bilateral
granulomatous uveitis which can occur anywhere from several weeks to
several years following injury of one of the eyes.Removal of a severely traumatized eye prior to development of
this inflammation will protect the other eye from sympathetic ophthalmia.This condition is felt to be an auto-immune reaction of the delayed
hypersensitivity type, possibly to uveal or retinal antigens.Clinically, this condition is characterized by a granulomatous
inflammation with large "mutton-fat" keratic precipitates and a
diffuse uveitis.Histopathologically,
sympathetic ophthalmia is characterized by a diffuse, granulomatous
inflammation of the uvea(#22252).This
inflammation classically spares the choriocapillaris(#22253).The inflammation is a granulomatous inflammation composed
predominantly of epithelioid cells which may form multi-nucleated giant
cells, as well as lymphocytes(#22255).Another characteristic feature of this inflammation is the
formation of Dalen-Fuchs' nodules(#22256, #22258).These nodules are comprised of epithelioid cells which are felt to
be derived from either the monocyte/macrophage cell line or possibly from
retinal pigment epithelial cells.These
nodules are located between Bruch's membrane and the retinal pigment
epithelium.
See also
(#22100) for another slide of sympathetic ophthalmia.
