A disorder known as symblepharon occurs when the eyelid becomes inappropriately attached to the eyeball as a consequence of scarring due to inflammation, infection, or trauma to the eye. Symblepharon may begin as a mild irritant but, if left unaddressed, can cause pain, limited eye movement, and possibly blindness. A significant distinction in treatment outcomes may be accomplished by identifying the symptoms early on, such as redness, eye stickiness, or decreased movement. A prompt diagnosis and appropriate care, such as medication or surgery, can help most people feel better and keep their eyesight intact. To ensure the best outcomes for patients with this complicated illness, skilled ophthalmologists at Wavikar Eye Institute place a strong emphasis on early intervention.
What Is Symblepharon?
An eye disorder called symblepharon damages the conjunctiva which is the thin, transparent membrane that covers the sclera (white portion of your eye). Your eyelids’ insides are lined with it as well. There is an adhesion between these two layers of your conjunctiva called a symblepharon (plural: symblephara).
When your eye tissues enlarge and adhere to one another due to extreme inflammation, it may consequently result in symblepharon. Scars may develop following inflammation, permanently joining the layers, causing one or more adhesions. Recurrent episodes of symblepharon occur due to persistent inflammation in the eye.
What Causes Symblepharon to Develop?
Conjunctivitis, or severe or persistent inflammation of the conjunctiva, can cause symblepharon. The white portion of your eyeball and the insides of your eyelids are lined with your conjunctiva. Severe swelling and inflammation can cause these tissues to adhere to one another. The adhesions become permanent as a result of scarring.
Keratoconjunctivitis, or inflammation of the cornea, can also occur sometimes. Your iris is protected by that transparent membrane, called cornea. Adhesions between your cornea and conjunctiva may result from this. Infections, wounds, and autoimmune disorders are among the conditions that can result in severe conjunctivitis or keratoconjunctivitis. Some examples include:
- Ocular herpes
- Adenoviral keratoconjunctivitis
- Trachoma
- Complications of eye surgery
- Chemical burns
- Adverse reaction to eye medications
- Graft vs. host disease
- Mucous membrane pemphigoid
- Ocular cicatricial pemphigoid
- Bullous pemphigoid
- Stevens-Johnson syndrome
- Erythema multiforme
- Lichen planus
- Sarcoidosis
- Scleroderma
- Granulomatosis with polyangiitis
What Are the Different Variants of Symblepharon?
| Variant | Description |
| Anterior Symblepharon | Adhesion between the eyelid edge and the eyeball surface. |
| Posterior Symblepharon | Involves the conjunctival fornix or cul-de-sac, leading to deeper adhesions. |
| Total Symblepharon | Complete fusion of the eyelid to the globe, obliterating the fornix. |
| Simple Symblepharon | Limited adhesions between the eyelid and eyeball conjunctiva, often affecting a small area. |
| Cicatricial Symblepharon | Extensive adhesions resulting from significant inflammation and scarring of the conjunctiva. |
| Fornix Symblepharon | Adhesions specifically form in the conjunctival fornices, the recesses between the eyeball and eyelids. |
| Congenital Symblepharon | Rare form present at birth, sometimes associated with conditions like cryptophthalmos. |
What Symptoms of Symblepharon Should You Watch For?
Symblepharon is visible in your eye. It seems to be a strip of tissue that joins your eyeball and inner eyelid. If it is not visible to you directly, you may detect that your eyeball can no longer move in all of its previous ways or that your eyelid does not open completely. Other possible symblepharon complications include:
- Ptosis: This condition pulls your eyelid down, resulting in eyelid drooping
- Entropion: Inward pushing of eye balls
- Lagophthalmos: Failure to close your eyes completely
- Diplopia: Limited eyeball movement, resulting in double vision
- Other symptoms include
- Eye irritation
- Redness
- Tearing
- Light sensitivity
- Dry eye
How Is Symblepharon Diagnosed?
With an eye exam, your eye care professional can detect symblepharon. To make eye examination simpler, they might give you eye drops. They will closely examine which tissues are linked and what is the site of attachment during your examination. Additionally, they will look for any complication related to your particular type of symblepharon.
In the event that your doctor is unable to determine the cause of your symblepharon, they may recommend further testing, such as an eye swab or a blood test. While some of the causative conditions will resolve with therapy, others might be long-term conditions that may persist and require continuous care.
What Are the Treatment Options for Symblepharon?
Preventing symblepharon is better than treating it. Your doctors advise you the ways to prevent symblephara (plural of symblepharon) if they are aware of your predisposition to them or if you have a disease that could cause them. They manage this by treating your underlying ailment and preventing inflammation between the surfaces of your conjunctiva. Your underlying disease may be treated medically by:
- Corticosteroids for inflammation
- Antibiotics or antivirals for infections
- Immunomodulators for autoimmune disease
Oral medications or as ocular drops may be advised. After your eye’s irritation has subsided, your doctor could apply an amniotic membrane covering to assist prevent or minimize scarring. In certain situations, they could surgically affix it to your eye, or it might be a disc that adheres like a contact lens.
You could require surgery to remove the adhesions if your doctor is unable to prevent symblepharon or is treating you after you have experienced it. The severity of symblepharon determines the type of surgery that is required. You could just require a simple operation, or you might require extensive oculoplastic surgery. Following are the techniques included:
| Procedure | Description |
| Symblepharon Release | Surgical separation of the adhesions between the conjunctival layers. May involve scar removal. |
| Tissue Graft | Replacement of damaged tissue using grafts from the eye itself or another mucous membrane (e.g., inner lip). |
| Oculoplastic Reconstruction | Reconstructive surgery of the conjunctival fornix or, if the cornea is affected, keratoplasty (corneal transplant). |
Conclusion
Most of the time, a symblepharon has no symptoms. It could only be identified by your doctor during a routine eye examination. If there aren’t any signs yet, it probably won’t do any damage. Determining the cause of your symblepharon and preventing more scarring are the most crucial things to do.
Get personalized advice on managing symblepharon at Wavikar Eye Institute.
FAQs
Q1: What causes Symblepharon to occur?
A: Common causes include chemical or thermal burns, infections, autoimmune eye diseases (like Stevens-Johnson syndrome), and eye trauma or surgery.
Q2: Is Symblepharon painful or dangerous?
A: It may not always be painful initially, but it can cause irritation, restricted eye movement, and, in severe cases, affect vision if left untreated.
Q3: Can Symblepharon go away on its own?
A: No, it usually requires medical or surgical treatment to release the adhesions and prevent recurrence.
