What is Symblepharon?

A symblepharon is a fibrous tract that connects bulbar conjunctiva toconjunctiva on the eyelid.

Symblepharon, Normal Fornix

Cosmetic & Reconstructive Facial Eyelid & Orbital surgery @ Eye Plastics.

Symblepharon, Upper Fornix

Description of the objects in the image and any embedded text.

When do symblepharon occur?

Cicatricial pemphigoid; auto-immune disease which affects mucus membranes such as the mouth and oral pharynx, conjunctiva, nares and genitalia
Atopic keratoconjunctivitis: This is a hypersensitivity to environmental allergies including asthma, rhinitis, dermatitis and eczema.
Trichiasis: A lid abnormality in which eyelashes are misdirected towards the eyeball. These misdirected lashes might often be the result of scarring.
Toxic epidermal necrosis (TEN): A potentially life-threatening disorder which is commonly drug-induced.

Stevens Johnson Syndrome
- Characteristics:
  - Equal age and sex distribution
  - Substantial disease associated with a 5-15% mortality rate
  - Ocular involvement in 50%
  - Associated with various infections and medications most notably sulfa
  Ocular involvement in 50%
- Pathogenesis:
  - Angiitis-->Erythematous lesion-->Bullae-->Rupture-->Scar
- Prodrome:
  - Fever, chills, and headache
  - 7 days later bullous mucosal lesions develop
- Sequelae:
  - Problems are related to the destruction of Goblet cells and a lack of conjunctival mucus which leads to keratinization and scarring.
  - Lid scarring with symblepharon
  - Corneal scarring
  - Keratitis sicc
Burns
Erythema multiforme: This is an acute multi-cutaneous hypersensitivity reaction

What are the treatment options?

Why use Amniotic membrane? Because it:
- facilitates epithelialization
- maintains normal epithelial phenotype (with goblet cells when performed on conjunctiva ),
- reduce inflammation, vascularization and scarring.

The use of {human} amniotic membrane for the surgical treatment of an ocular surface disorder was originally reported by de Rotth ¹⁶ in 1940. During the 1990s, the role of amniotic membrane transplantation in treating a variety of ocular surface defects and abnormalities has been revived.

Chemical Burns

Image of an eye condition called Symblepharon, showing the adhesion between the eyelid and the eyeball