Wibowo Edy, Maharani Regina Vika, Sutikno Nadya Adiwijaya
Opthalmology Department, Bethesda Hospital Yogyakarta, Indonesia.
Universitas Kristen Duta Wacana, Faculty of Medicine, Yogyakarta, Indonesia.
Rom J Ophthalmol. 2024 Oct-Dec;68(4):466-469. doi: 10.22336/rjo.2024.84.
Stevens-Johnson syndrome (SJS) is a life-threatening condition resulting from a severe reaction to the use of certain drugs, with the highest incidence found in children. It manifests as a triad of skin, orifice, and ocular mucosa lesions. Ocular manifestations most commonly involve the conjunctiva and eyelids. This case report further discusses symblepharon as an ocular manifestation of SJS.
A case report.
A 10-year-old boy came with decreased vision and an inability to produce tears. On examination, pseudomembranous conjunctivitis was found in both eyes, granulation tissue in the right eye, and erosion of the corneal epithelium in the left eye. The posterior segment could not be assessed due to symblepharon. It was known that the patient previously experienced SJS in early 2023. Symblepharectomy was carried out with the indication of separate adhesions caused by symblepharon.
Symblepharon is a rare, severe ocular manifestation of SJS (Stevens-Johnson syndrome). Previous studies found that severe ocular occurred in around 4% and 11.1% of cases. This happened because of ongoing chronic inflammation due to SJS. Symblepharon is an adhesion of eyelids and bulbar conjunctiva, which can harm the eye because it can cause cicatricial then disruption of the tear film meniscus, limit eye mobility, and cause visual disturbances.
Symblepharon occurs due to prolonged inflammation, which can structurally and functionally disrupt the eye. Early discovery of symblepharon, especially in severe manifestations of SJS, can help prevent further damage to the eye.
史蒂文斯-约翰逊综合征(SJS)是一种因使用某些药物产生严重反应而危及生命的疾病,在儿童中发病率最高。它表现为皮肤、孔窍和眼黏膜病变三联征。眼部表现最常见于结膜和眼睑。本病例报告进一步探讨了睑球粘连作为SJS的一种眼部表现。
病例报告。
一名10岁男孩因视力下降和无泪前来就诊。检查发现双眼均有假膜性结膜炎,右眼有肉芽组织,左眼角膜上皮糜烂。由于睑球粘连,无法评估眼后段。已知该患者在2023年初曾患SJS。因睑球粘连导致的粘连分离而进行了睑球粘连分离术。
睑球粘连是SJS(史蒂文斯-约翰逊综合征)一种罕见的严重眼部表现。先前的研究发现,严重眼部病变在约4%和11.1%的病例中出现。这是由于SJS持续的慢性炎症所致。睑球粘连是眼睑与球结膜的粘连,会对眼睛造成损害,因为它会导致瘢痕形成进而破坏泪膜半月皱襞,限制眼球活动,并引起视觉障碍。
睑球粘连是由于炎症持续时间过长导致的,可在结构和功能上破坏眼睛。早期发现睑球粘连,尤其是在SJS的严重表现中,有助于预防眼睛进一步受损。