title: Sympathetic ophthalmia in Singapore: new trends in an old disease.
abstract: BACKGROUND
  Sympathetic ophthalmia (SO) is an uncommon uveitic condition that occurs after injury to the uvea of one eye and may occur after accidental ocular trauma or ocular surgery. We sought to investigate the common causes of SO in Singapore and the demographic profile as well as the final visual acuity after treatment in these patients.
  
  
  METHODS
  This was a retrospective, non-comparative case series in which patients with SO were identified from the Singapore National Eye Centre uveitis database in the period between 1993 and 2003. The patients' case records were examined for a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO or histopathological evidence of SO in enucleated eyes. The medical records of these patients were reviewed for details of the inciting event, presentation, treatment, and visual acuity.
  
  
  RESULTS
  A total of ten patients (six men and four women) were diagnosed with SO in the period of study. SO occurred after accidental trauma in three patients and following ocular surgery in seven. Vitreoretinal surgery was responsible for four of these cases, and diode laser cyclophotoablation for another two, whereas neodymium:yttrium-aluminium-garnet (Nd:YAG) laser cyclotherapy was the cause in the last patient. Overall, six of ten patients underwent at least one vitreoretinal procedure. Four of the patients had a final visual acuity of 6/15 or better, whereas five had a visual acuity of 6/30 or worse. Good final visual acuity appeared to be associated with early initiation of immunosuppressive therapy.
  
  
  CONCLUSIONS
  In this series, ocular surgery, especially vitreoretinal surgery, had overtaken non-surgical trauma as the major cause of SO. A good outcome was possible in most cases if an early diagnosis was made and immunosuppressive treatment started promptly.
authors: Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore. dannysu22@yahoo.com.sg
authors: Daniel Hsien-Wen
authors: DH
authors: Su
authors: Soon-Phaik
authors: SP
authors: Chee
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009879:Ophthalmia, Sympathetic / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D014792:Visual Acuity
chemical_list: D007166:Immunosuppressive Agents