Granulomatous uveitis after treatment of a choroidal melanoma with proton-beam irradiation.

Histologic examination of an eye removed 2 years after receiving proton-beam irradiation for a choroidal melanoma revealed residual tumor in the choroid and nonnecrotizing granulomatous inflammation, consistent with the diagnosis of early sympathetic ophthalmia. Sutures that secured four tantulum rings to the sclera did not penetrate the uvea. Sympathetic ophthalmia without evidence of a perforating injury has been described previously after helium ion therapy. The findings in our case further support the hypothesis that there is a risk of developing sympathetic ophthalmia after charged-particle therapy in the absence of a penetrating injury of the uveal tract.