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Symblepheron

In this condition, lids become adherent with the eyeball as a result of adhesions between the palpebral and bulbar conjunctiva

Etiology :
It results from the healing of kissing raw surfaces upon the palpebral and bulbar conjunctiva. Its common causes are chemical burns, injuries, membranous conjunctivitis, conjunctival ulcerations, ocular pemphigus and Stevens - Johnson syndrome.

Clinical picture :
Difficulty in lid movements, lagophthalmos, diplopia and cosmetic disfigurement

Complications :
Dryness, thickening and keratinisation of conjunctiva due to prolonged exposure and corneal ulceration

Treatment :
Prophylaxis - During the stage of raw surfaces, the adhesions may be prevented by sweeping a glass rod coated with lubricant around the fornices several times a day. A large sized , therapeutic , soft contact lens also helps in preventing the adhesions.

Curative treatment consists of symblepherectomy. The raw area created may be covered by mobilising the surrounding conjunctiva in mild cases. Conjunctival or buccal or mucosal graft is required in severe cases.

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