Sympathetic ophthalmia

Also: sympathetic ophthalmitis

A rare inflammation that can attack the healthy eye after the other eye is penetrated. Fear of it shaped how many eyes surgeons removed.

Questions this entry answers

  • What is sympathetic ophthalmia?
  • Can an injury to one eye cause blindness in the other?
  • Why did doctors remove injured eyes in the past?

Definition

Sympathetic ophthalmia is an inflammation of the uninjured eye that can follow a penetrating injury to the other eye. It can develop weeks or months after the injury and can lead to blindness in both eyes.

Historical context

The condition was recognised long before it was understood. For surgeons working before modern drugs, the only reliable way to remove the risk was to remove the injured eye early. That logic drove many of the eye removals after mass-casualty events, including the Halifax Explosion of 1917.

How it worked

The surgeon's choice was a trade. Leave a badly damaged eye in place and hope, knowing it might take the good eye with it. Or remove it and accept the certain loss of one eye to protect the other. Patients in Halifax who later wrote to the Blind Relief Fund described being told exactly this: the injured eye had to come out to save the other.

What it meant for the patient, the soldier, the civilian

A patient who had just lost the sight of one eye was asked to give up the eye itself, to prevent something that might never happen. Most agreed. Some of those eyes might have been kept. Capt. Frederick Tooke, who took over eye surgery at Camp Hill on the fifth day, asked publicly afterwards whether too many had been removed. The question has no clean answer, and we leave it open.

Examples from history

  • Halifax, 1917. 249 eyes were removed from 592 people with eye injuries. Fear of sympathetic ophthalmia was the main reason given.

Sources

Sources listed
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Primary source

  1. Tooke, F. T. "An experience through the Halifax disaster." Canadian Medical Association Journal 1918;8(4):308–320. View source

    Not yet checked against the source

Scholarly secondary source

  1. McAlister, C. N., Murray, T. J., Lakosha, H., Maxner, C. E. "The Halifax disaster (1917): eye injuries and their care." British Journal of Ophthalmology 2007;91:832–5. View source

    Not yet checked against the source

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