Sympathetic ophthalmia is a bilateral granulomatous panuveitis. The inciting antigen responsible is most likely derived from:
- A Uveal melanocytes and photoreceptor outer segment antigens sequestered behind blood-ocular barrier ✓
- B Lens crystallin proteins released after penetrating injury
- C Corneal stromal proteoglycans exposed to systemic immune surveillance
- D Retinal ganglion cell proteins expressed after optic nerve injury
Explanation
Sympathetic ophthalmia is an autoimmune granulomatous uveitis affecting both eyes following penetrating trauma or surgery to one eye. The initiating event is disruption of the blood-ocular barrier, exposing retinal/uveal antigens (particularly uveal melanocyte proteins like tyrosinase-related proteins, and photoreceptor antigens such as S-antigen/arrestin and interphotoreceptor retinoid-binding protein — IRBP) that are normally sequestered from immune surveillance. These antigens trigger a Th1-mediated delayed hypersensitivity response affecting both the injured ('exciting') eye and the healthy ('sympathizing') eye. Histologically, it shows Dalen-Fuchs nodules between RPE and Bruch's membrane.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.