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Ophthalmology · Uvea: sympathetic ophthalmia presentation
Sample itemSix weeks after a perforating injury in one eye, the other uninjured eye becomes photophobic and red with mutton-fat keratic precipitates. What is the most appropriate treatment for the uninjured eye?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. High-dose systemic corticosteroids
Sympathetic ophthalmia is a bilateral granulomatous uveitis after penetrating injury, treated with high-dose systemic steroids and immunosuppressants. The sympathising eye is never removed because it may retain useful vision. Early enucleation of a blind injured eye reduces risk but is not done once disease begins.
Option by option
A. Topical antibiotics
Topical antibiotics do not treat an immune disorder.
B. High-dose systemic corticosteroids (correct)
Correct. Systemic steroids control the immune uveitis and save the sympathising eye.
C. Observation
Observation risks severe vision loss.
D. Enucleation of the uninjured eye
Removing the sympathising eye would sacrifice the better-seeing eye.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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