Stevens-Johnson Syndrome / TEN (Acute Ocular Involvement)

Overview

Acute Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with ocular involvement — a life- and sight-threatening drug/immune mucocutaneous emergency, distinct from the chronic ocular sequelae seen years later. In the acute phase the ocular surface undergoes epithelial sloughing, pseudomembrane and symblepharon formation, and conjunctival/corneal breakdown over days. Any patient with a widespread mucocutaneous blistering reaction and eye redness, pain, discharge, or lid/conjunctival membranes needs same-day ophthalmology assessment for acute-phase grading and surface protection; the systemic illness is managed in hospital (often burns/ICU). Common triggers: sulphonamides, anticonvulsants (lamotrigine, carbamazepine, phenytoin), allopurinol, NSAIDs, and some antibiotics.