A Case of Sympathetic Ophthalmia Presenting with Extraocular Symptoms and Conjunctival Pigmentation after Repeated 23-gauge Vitrectomy

Purpose: To report a case of sympathetic ophthalmia presenting with extraocular symptoms after 23-gauge sutureless vitrectomy.Methods: Observational case report.Results: A 29-year-old woman underwent 23-gauge sutureless vitrectomy for spontaneous rhegmatogenous retinal detachment in the right eye. After vitrectomy, dense conjunctival pigmentations developed around the sclerotomy sites. One month after the second vitrectomy for a recurred retinal detachment, she presented with decreased visual acuity and metamorphopsia in both eyes, headache, tinnitus, and facial swelling. She was diagnosed with sympathetic ophthamia and treated with oral prednisolone and cyclosporine. Her visual acuity and symptoms improved after treatment.Conclusion: Sympathetic ophthalmia can occur after 23-gauge sutureless vitrectomy and conjunctival pigmentation may be the preceding sign.