Sympathetic ophthalmia following a conjunctival flap procedure for corneal perforation

A 25-year-old man developed diminution of vision and redness in both eyes 5 weeks after a conjunctival flap procedure in the right eye. On examination, there was panuveitis and exudative retinal detachment in both eyes. The right eye had an inferotemporal conjunctival flap with iris incarceration. Fundus fluorescein angiography revealed typical pinpoint leaks and optical coherence tomography demonstrated multiple neurosensory detachments in the left eye. The patient received frequent topical steroids and cycloplegics. Intravenous dexamethasone pulse was given followed by high-dose oral prednisone, after which the patient recovered vision. The conjunctival flap in corneal perforation may predispose to sympathetic ophthalmia.