Symblepharon:

Symblepharon: 

Symblepharon is a pathological condition where the bulbar and palpebral conjunctiva form an abnormal adhesion to one another. This condition can be acquired due to a number of inflammatory or traumatic etiologies. Immune-mediated inflammatory conditions include Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis, ocular cicatricial pemphigoid, and mucous membrane pemphigoid. Traumatic causes include chemical burns, thermal burns, and mechanical trauma.

Causes 

There are many causes of symblepharon, which is typically a response to trauma or inflammation.  In no particular order, here are some of those causes:

• Ocular cicatricial pemphigoid
• Pseudopemphigoid conditions
• Stevens-Johnson syndrome
• Trauma
• Conjunctival burns
• Atopic keratoconjunctivitis
• Porphyria cutanea tarda
• Rosacea
• Epidemic keratoconjunctivitis
• Xeroderma pigmentosum
• Squamous papilloma of the conjunctiva

Symptoms

• Ocular motility disorders
• Diplopia
• Entropion
• Inadequate lids closure
• Signs: adhesion between bulbar and palpebral conjunctiva

May occur as a complication of various ocular diseases such as: dry eye syndrome, Stevens-Johnson syndrome, cicatricial pemphigoid, chemical injury, erythema multiforme, pemphigus bullosa or as a complication of chemical burn.

Any conjunctival infections complicated with conjunctival scaring may cause symblepharon; chlamydial conjunctivitis, vernal, atopic, bacterial conjunctivitis and epidemic keratoconjunctivitis.

Diagnosis

The diagnosis of symblepharon involves a thorough eye examination, including a slit-lamp examination to evaluate the extent of the adhesion. The ophthalmologist may also perform a Schirmer test to evaluate tear production and a fluorescein staining test to evaluate the cornea.