A 19-year-old man comes to the office due to eye pain and blurry vision in both eyes for the last several days. He sustained an open globe injury to the right eye 3 months ago after being struck during an altercation and was treated with surgical repair and prophylactic antibiotics. The left eye was unaffected. At the patient's last follow-up appointment, visual acuity in the right eye had improved from 20/400 to 20/80. He is otherwise healthy. Temperature is 37.1 C (98.8 F). Examination is unremarkable apart from bilateral conjunctival injection and decreased visual acuity in both eyes. Analysis of vitreous samples from both eyes demonstrates multinucleated giant cells. Which of the following mechanisms is most likely causing this patient's current manifestations?

Question

A 19-year-old man comes to the office due to eye pain and blurry vision in both eyes for the last several days.  He sustained an open globe injury to the right eye 3 months ago after being struck during an altercation and was treated with surgical repair and prophylactic antibiotics.  The left eye was unaffected.  At the patient's last follow-up appointment, visual acuity in the right eye had improved from 20/400 to 20/80.  He is otherwise healthy.  Temperature is 37.1 C (98.8 F).  Examination is unremarkable apart from bilateral conjunctival injection and decreased visual acuity in both eyes.  Analysis of vitreous samples from both eyes demonstrates multinucleated giant cells.  Which of the following mechanisms is most likely causing this patient's current manifestations?

Quizplus · Accepted Answer

Eductional Objective: Traumatic injury to the eye, a site that displays immune privilege, can lead to the release of previously sequestered antigens that T cells recognize as foreign.  This can lead to sight-threatening inflammation in both the injured and uninjured eye.

A 19-Year-Old Man Comes to the Office Due to Eye