Sympathetic Ophthalmia as a Major Sight-threatening Disorder.

SO Iris and eyeball inflammatory condition affecting both eyes that occurs after a penetrating injury as a delayed autoimmune reaction to eye injury. Patients present with pain, photophobia, paresis of accommodation, metamorphopsia and mild to significant visual loss. The granulomatous anterior uveitis is accompanied by posterior segment findings including moderate to severe vitritis, choroiditis, papillitis, perivasculitis, and yellow-white lesions of the retinal pigment epithelium (Dalen-Fuchs nodules). The inflammation can lead to serious retinal detachment and macular edema. Extraocular symptoms include headache, meningitis or cerebrospinal fluid pleocytosis, hearing loss, poliosis and vitiligo. The inflammation is caused by a cell-mediated immune mechanism and autoimmune inflammatory response directed against ocular self-antigens released after the initial injury. SO may occur after ocular trauma (47 to 65% of patients) or contusions. Wounds involving the ciliary body are associated with the highest risk. Surgical interventions may also trigger SO, with posterior segment surgery carrying a higher risk than anterior segment surgery. Diagnosis of SO is mainly based on patient history and clinical presentation. Imaging studies (fluorescein or indocyanine green angiography, B-scan ultrasonography and optical coherence tomography) may be useful to confirm the diagnosis.

Analysis of 967 Cases of Drug-induced Ophthalmic Injuries / 中国药房

OBJECTIVE:To review the occurrence of ophthalmic injuries and analyse the relationship between the injuries and the kinds of drugs used and the route of administration METHODS:The cases of drug-induced ophthalmic injuries which were reported in medical journals published from 1960 to 2000 year were collected and analysed RESULTS:There were 967 cases of drug-induced ophthalmic injuries caused by 154 kinds of drug The clinical manifestations of ophthalmic injuries included ocular pigmentation,visual disturbance,loss of sight and injuries to cornea,conjunctiva,optic nerve,retina or optic papilla,and the inducing drugs were mostly antimicrobials,central nervous system and circulatory system drugs,such as chlorpromazine,perphenazine,amiodaron,ethambutol etc CONCLUSION:Drug-induced ophthalmic injuries caused by systemic administering drugs in commonly-used dosage and route pertain to ADRs The ophthalmic injuries caused by local application of drugs to the eyes result from improper drugs used,faulty manipulation and unsuitable applications of drugs during or after operations