Symblepharon

Symblepharon is a medical condition characterized by the adhesion of the eyelid to the eyeball. This adhesion can involve the conjunctiva, the thin membrane that lines the inner surface of the eyelids and covers the white part of the eye. Symblepharon can range from a mild attachment to a complete fusion, significantly impairing vision and eyelid movement.

The primary cause of symblepharon is inflammation or injury to the conjunctiva. This can result from various factors, including severe dry eye disease, chemical burns, thermal injuries, infections like ocular pemphigoid or Stevens-Johnson syndrome, and prolonged use of certain medications. Trauma to the eye, such as abrasions or surgical procedures, can also lead to its development.

Symptoms vary depending on the severity and extent of the adhesion. Mild cases may cause discomfort, a gritty sensation, or foreign body sensation. More severe symblepharon can restrict eye movement, leading to double vision, difficulty closing the eyelid completely, and reduced visual acuity due to obstruction of the pupil. It can also make it difficult to wear contact lenses or undergo eye examinations.

Diagnosis is typically made through a physical examination of the eye by an ophthalmologist. The extent of the adhesion can be assessed using specialized instruments. Treatment aims to release the adhesion and restore normal eyelid function. This may involve conservative measures like lubrication and artificial tears for mild cases. For more significant symblepharon, surgical intervention may be necessary to dissect the adhesions. Grafting of conjunctival or mucous membrane tissue may be required to prevent re-adhesion after surgery. Early diagnosis and management are crucial to prevent complications and preserve vision.