Purulent infection of the exciting eye in sympathetic ophthalmia (SO) is believed to confer protection against the development of SO. Vasculitis with perivascular chorioretinal scars (PCRS) is rarely seen in SO. We report a child who developed SO while on treatment for traumatic endophthalmitis. Along with a typical picture of SO, exudative retinal vasculitis was seen, which developed PCRS at a resolution similar to tubercular vasculitis. Remission was achieved with 5 years of immunomodulatory therapy. No recurrence was seen during the next 2.5 years of follow-up without medications. Our case highlights atypical presentation and refutes the theory that purulent infection may be protective against SO.