Sympathetic ophthalmia (SO) is a rare, bilateral, diffuse granulomatous uveitis that usually occurs after open globe injury or intraocular surgery. A patient developed SO following therapeutic penetrating keratoplasty (TPK) with cataract extraction in the exciting eye following fungal keratitis. The sympathizing eye presented with only posterior segment findings (exudative retinal detachment) and responded well with oral corticosteroids. Graft remained clear in the left eye and the right eye; the best-corrected visual acuity (BCVA) improved to 0.2 log MAR. SO presenting after TPK for fungal keratitis is a rare occurrence but if detected early can be managed effectively.
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