Sympathetic ophthalmia

An autoimmune eye disease in which a penetrating injury to one eye produces inflammation in the uninjured eye.

(The injured eye is termed the 'exciting' eye while the uninjured one is the 'sympathetic' eye.) The original eye injury always involves the uvea, specifically the ciliary body, releasing uveal pigment into the bloodstream.

This triggers the formation of antibodies which cause inflammation of the uvea (uveitis) in the uninjured eye with gradually progressive loss of vision.

The symptoms are blurry vision and pain in both eyes.

The time between the injury in the exciting eye and the onset of disease in the sympathetic eye is generally 2 weeks to 2 months.

The disease then typically runs a chronic progressive course with periods of quiescence punctuated by renewed inflammation.

Treatment is the prompt and aggressive administration of corticosteroids and, if need be, other anti-inflammatory drugs.

Enucleation (removal) of the injured eye within 14 days of the injury will prevent sympathetic ophthalmia.

This is clearly a drastic remedy.

Sympathetic ophthalmia has been known since the time of Hippocrates.

The writer James Thurber (1894-1961) was left blind in one eye by an arrow during a game of William Tell.

Sympathetic opthalmia rendered him totally blind by his 40s.

Also known as sympathetic uveitis or transferred ophthalmia.