Cornea · Stevens-Johnson syndrome — ocular manifestations

Stevens-Johnson syndrome

Stevens-Johnson syndrome (SJS) is a dermatologic emergency, characterized by the presence of epidermal and mucosal bullous lesions involving less than 10% of the total body surface area (TBSA) Bilateral conjunctival hyperemia with purulent discharge is the most common ocular finding at initial presentation and is seen in 78% of acute SJS cases. Conjunctivitis may present prior, during or following the development of skin eruptions. As the disease course progresses, inflammatory changes to the ocular surface may lead to the development of bulbar and conjunctival ulcerations with subsequent pseudomembrane formation, epithelial sloughing, anterior uveitis, panophthalmitis, corneal ulceration, and corneal perforation. There is a high correspondence between sites of bulbar and tarsal conjunctival ulceration in the acute phase and development of symblepharon, subconjunctival scarring, and posterior lid margin keratinization in the late phase of SJS. For this reason, it is highly recommended that individuals with SJS with ocular involvement receive thorough exams, including eversion the upper and lower lids to check for sites of bulbar and palpebral conjunctival ulceration. Doing so will allow early recognition and intervention that will lessen the likelihood of these late phase manifestations of SJS and spare the cornea insults secondary to these adnexal changes.

Contributed byShadab AhmadOptometrist, Internship ( UPUMS )

Read the full topic Browse the Image Vault