Stevens-Johnson Syndrome

What is Stevens-Johnson Syndrome?

Stevens-Johnson Syndrome (SJS) and its more severe variant, toxic epidermal necrolysis, are serious disorders involving the skin and mucous membranes. Typically, patients develop flu-like symptoms followed by a rash that spreads and blisters. Various body parts can be involved, including the mouth, eyes, palms and soles. This syndrome can cause serious eye problems, such as severe conjunctivitis, scarring of the conjunctiva (thin membrane that lines the inner surface of the eyelid and covers the sclera), severe ocular dryness, corneal erosions and even corneal perforation. In advanced cases, ocular complications caused by SJS can lead to profound permanent vision loss.

Causes:

The cause of SJS remains poorly understood. It is most commonly thought to be an adverse reaction to a medication or infection.

Treatment:

SJS is a medical emergency and requires treatment in a hospital, often in a burn unit or intensive care unit. Treatment and management of acute SJS consist of supportive measures (IV fluids, wound care, pain relief). An ophthalmologist should always be involved in the acute care of patients with SJS. Acute ocular treatments may include lubrication with artificial tears and ointments, topical corticosteroids, bandage contact lenses, and amniotic membrane application. Chronic treatments may also include scleral prostheses, known as PROSE, to help restore vision and support the impaired ocular surface. Involving an ophthalmologist early in the treatment of acute SJS is important to achieve better ocular outcomes.


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