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Ophthalmology · Uveitis
Sample itemThree weeks after a penetrating injury to his right eye, a 25-year-old develops pain, photophobia and reduced vision in the uninjured left eye as well. Histology of the injured eye shows granulomatous inflammation with Dalen-Fuchs nodules. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Sympathetic ophthalmia
Sympathetic ophthalmia is a bilateral granulomatous panuveitis following penetrating trauma or surgery to one eye, caused by an autoimmune reaction against uveal antigens. Dalen-Fuchs nodules are characteristic, and early enucleation of a blind injured eye can prevent it, while steroids and immunosuppressants treat established disease.
Option by option
A. Endophthalmitis of the left eye
Endophthalmitis is infective and does not appear in the other, uninjured eye.
B. Sympathetic ophthalmia (correct)
Correct. Bilateral granulomatous uveitis after trauma with Dalen-Fuchs nodules defines it.
C. Fuchs heterochromic iridocyclitis
Fuchs heterochromic iridocyclitis is a chronic unilateral, mild uveitis without synechiae and without a history of trauma.
D. Phacoanaphylactic uveitis
Phacoanaphylactic uveitis is a response to lens protein in the same 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.