Long-Term Management of Sympathetic Ophthalmia Developing in the Early Period Following Trauma: A Case Report.

This case report presents a rare instance of sympathetic ophthalmia (SO) in a patient who developed globe rupture due to blunt ocular trauma. It provides insights into the clinical course and three-year follow-up of successful treatment achieved through systemic immunosuppressive therapy. A 45-year-old male patient sustained blunt trauma to his left eye. Due to clinical signs indicative of rupture, conjunctival exploration was performed, revealing a scleral rupture that was primarily repaired. On postoperative day 18, the patient developed bilateral panuveitis consistent with trauma-induced SO. Diagnosis was supported by clinical signs, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA). Treatment included systemic corticosteroids and immunosuppressive agents (cyclosporine and azathioprine), with dose adjustments during follow-up. Three years later, following cataract surgery, visual acuity in the injured eye improved to 0.7 (Snellen). OCT and FFA findings normalized, and systemic therapy was well tolerated except for mild gingival hyperplasia attributed to cyclosporine. This case underscores the importance of early diagnosis and aggressive immunosuppressive therapy in managing early-onset SO following globe rupture. Long-term follow-up demonstrated effective inflammation control and stable visual acuity, supporting the efficacy of combined immunosuppressive therapy.