Sympathetic ophthalmia in a patient with a history of recurrent presumed tubercular multifocal choroiditis and multiple ocular surgeries

A 61-year-old male presented with multiple episodes of presumed tubercular choroiditis. He also underwent multiple trabeculectomies in the right eye with subsequent loss of vision and phthisis bulbi in this eye. A few years later, he developed a granulomatous panuveitis in the left eye that was highly suggestive of sympathetic ophthalmia (SO). Infectious and then noninfectious ocular inflammatory conditions in this patient shared several clinical and ocular imaging findings. Their careful analysis was critical to distinguishing between these entities, which had important therapeutic implications. The diagnosis and management of SO is challenging in the setting of prior recurrent presumed tubercular choroiditis.