Conjunctiva
Stevens-Johnson Syndrome (Ocular Sequelae)
Also known as: SJS, Stevens Johnson, toxic epidermal necrolysis, ocular sequelae SJS, symblepharon, cicatrising conjunctivitis
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Ocular sequelae of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Systemic mucocutaneous disease with acute and chronic ocular involvement. Chronic complications include symblepharon, dry eye, lid malposition, trichiasis, limbal stem cell deficiency, and corneal vascularisation. Long-term management: control inflammation, treat dry eye, manage trichiasis and lid pathology. Be cautious when changing or introducing new medications — can trigger severe exacerbation.
Recognition
Symptoms: what patients report
- Very dry and sore eyes despite lubricants.
- Blurred vision.
- Recurrent episodes of swelling, redness, irritation.
- Trichiasis — lashes touching globe.
Signs: what the examination shows
- Symblepharon — fusion of bulbar and forniceal conjunctiva.
- Vascularised corneal pannus.
- Punctate epithelial erosions, particularly inferior.
- Low Schirmer values (e.g. 2–4 mm in 5 minutes).
- Trichiasis, lid margin keratinisation, entropion.
- Chronic conjunctivitis with minimal discharge.
What OptoGuide™ covers for stevens-johnson syndrome (ocular sequelae)
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Stevens-Johnson Syndrome — EyeWiki
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Challenges and advances in ocular mucous membrane pemphigoid (OMMP); from pathogenesis to treatment strategies. Ghanbari H, Rahimi M, Momeni A, et al. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrec
- Microbial Keratitis in Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Experience From a Tertiary Centre in Taiwan. Tsai TY, Adiyabazar D, Hsiao CH, et al. Cornea. 2023;42(1):66-73.
- Immunological Interplay at the Ocular Surface of Stevens-Johnson Syndrome, Ocular Cicatricial Pemphigoid, and Ocular Graft Versus Host Disease. Pingali T, Sethu S, Kommana S, et al. Investigative Ophthalmology & Visual S
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.