Stevens-Johnson Syndrome and the Eyes
Published on in A Child's Sight
Published on in A Child's Sight
As part of a busy children’s hospital, the Division of Ophthalmology at CHOP consults on many challenging situations. Stevens-Johnson syndrome (SJS) is a lifethreatening cutaneous immune-mediated reaction involving blistering and desquamation of the skin and mucous membranes. When more than 30 percent body surface area is involved, the disease is called toxic epidermal necrolysis (TEN). Most often a drug is the cause, but infectious triggers and idiopathic cases also occur.
Ocular complications of SJS/TEN are vision-threatening and require quick and aggressive intervention. Acute inflammation of the entire ocular surface, from eyelid margins to conjunctiva to cornea, can cause symblepharon, corneal epithelial defects, and limbal stem cell loss, which can lead to vision loss and problems that persist long after the rest of the body has healed.
Gil Binenbaum, MD, MSCE, chief of the inpatient consultation service at CHOP, stresses a few key points:
A) Amniotic membrane graft sewn in place with external bolsters. B) Patient in recovery phase. The AMGs have dissolved. The bolsters have not yet been removed. C) Child who developed ocular surface failure and ocular cicatricial pemphigoid 1 year after acute SJS/TEN event.
Categories: A Child's Sight Spring 2014, Ophthalmology