Increased incidence of sympathetic ophthalmia observed in a pediatric open-globe-injury population

Abstract

Purpose: Sympathetic ophthalmia (SO) after open-globe injury is a rare, potentially devastating disease with an estimated incidence between 0.2-0.5% in the general population. This study examines the incidence and characteristics of SO in a pediatric versus adult open-globe injury population.

Methods: We reviewed all open-globe injuries presenting to the Massachusetts Eye & Ear Infirmary between 1999 and 2010. Inclusion required primary repair by a standardized protocol at this institution. Pediatric patients were defined as <18 years of age.

Results: One-hundred-and-forty-four pediatric and 721 adult open-globe injuries met inclusion criteria. Two pediatric (1.4%) and two adult (0.27%) cases of SO were documented.

Conclusions: Our data suggests a higher rate of SO in the pediatric population. This should alert treating ophthalmologists to look for this devastating complication, especially in children who can be difficult to examine. We speculate that immune-senescence may contribute to declining rates of SO with age. We suggest that a meta-analysis of pediatric versus adult open-globe injuries be performed to further elucidate whether this finding holds across populations.

Keywords: 432 autoimmune disease