Posters

Bilateral symblepharon complicating fibrosing conjunctivitis on drug toxidermy

Poster Details

First Author: A.Siati MOROCCO

Co Author(s): M. Bellamine   S. Homaid   A. Mchachi   L. Benhmidoune   R. Rachid   M. Elbelhadji     

Abstract Details

Purpose:

The syndrome of fibrosing conjunctivitis corresponds to a chronic conjunctivitis and synéchiante. Major ocular surface alterations, potentially blinding, are possible. To know and know how to diagnose the etiologies of the conjunctivitis fibrosing are the necessary conditions to propose a suitable treatment. The definitive diagnosis of autoimmune conjunctivitis must be made before proposing a treatment that may consist of systemic cytotoxic chemotherapy that does not have severe side effects. Finally, in the advanced stage, visual rehabilitation techniques may be necessary. OBJECTIVE: To report the case of chronic fibrotic conjunctivitis complicated by a bilateral symblepharon on drug-induced drug.

Setting:

It is a patient aged 23 years, hospitalized 2 years ago for medicinal toxidermy (undocumented), followed for dry syndrome since her hospitalization (poorly monitored by socio-economic conditions), addressed by her ophthalmologist for management of a bilateral symblepharon complicating a fibrosing conjunctivitis on medicinal toxidermy.

Methods:

The patient reported a bilateral decrease in visual acuity with photophobia, tearing, and feeling of foreign bodies. The clinical examination found at the level of the right eye a visual acuity without correction (AVsc) with positive light perception, a temporal and super-temporal symblepharon invading the subtotality of the cornea with superficial and deep neovessels over 360 °. Break Up Time was less than 4 sec. The rest not seen. Examination of the eye adelphe found a AVsc to count the fingers closely with a sympephépharon nasal invading the visual axis and a BUT lower than 6 sec.

Results:

Conduct was the symblépharon cure with oral mucosa and symblépharon ring placement. The remainder of the treatment consists of ATB eye drops (prophylaxis), local corticoids, artificial tears without preservatives and autologous serum. The evolution at day 21 was good. At the level of the OD, the AVsc has reassembled the fingers close and free conjunctival sacs asses. In the anterior segment: Opacity of corneal sequelae with perforation of 2mm / 1mm. At the OG level, the AVsc is 1/10 and 3/10 with correction, free conjunctival sac and freeze epithelial opacity.

Conclusions:

Fibrosing conjunctivitis syndrome involves two main mechanisms: Severe dry syndrome and creation of mechanical irritating spines.The conjunctival biopsy is easily performed after subconjunctival injection of lidocaine. The sample is taken from the conjunctiva bulbar perilimbic. The area left bare is filled by a fragment of amniotic membrane epithelium upwards, maintained by a drop of biological glue. It is useful for the diagnosis of etiology.The therapeutic approach is based on the treatment of the dry syndrome and the reconstruction of the conjunctiva and eyelids. Visual rehabilitation uses scleral lenses. Ocular surface reconstruction involves cell therapy and keratoplasty in 2nd position.

Financial Disclosure:

None