Stevens-Johnson Syndrome

What is it?

Hypersensitivity reaction to micro-organisms or medications (also called erythema multiforme, toxic epidermal necrolysis)
Medications most commonly implicated: sulfonamides, anticonvulsants, salicylates, penicillin
Vesiculobullous eruption on skin, mucous membranes
Conjunctiva often involved, sometimes leading to scarring, dry eye, corneal clouding
Early intensive lubrication, corticosteroid treatment, amniotic membrane grafts may preserve vision

In acute phase, redness, swelling of conjunctiva, tearing, mucous discharge from both eyes
In chronic phase, scarring and shortening of conjunctival fornix (symblepharon), drying and clouding of cornea

Infectious conjunctivitis (especially chlamydial, including trachoma), but eruption chronic and confined to eyes
Allergic conjunctivitis, but manifestations more chronic
Orbital cellulitis, but inflammation more in tissues around eyes
Episcleritis and scleritis, but onset is slower
Graves disease, but proptosis and lid retraction usually evident
Cavernous sinus arteriovenous fistula, but findings confined to eyes
Chronic cicatricial pemphigoid, but manifestations more chronic

Refer urgently to ophthalmologist if eyes appear involved, as topical treatments will be necessary