title: Stevens-Johnson syndrome: The role of an ophthalmologist.
abstract: Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. Acute SJS leads to the acute inflammation of the ocular surface and chronic conjunctivitis. If not properly treated, it causes chronic cicatricial conjunctivitis and cicatricial lid margin abnormalities. Persistent inflammation and ulceration of the ocular surface with cicatricial complications of the lids leads to chronic ocular sequelae, ocular surface damage, and corneal scarring. The destruction of the glands that secrete the tear film leads to a severe form of dry eye that makes the management of chronic SJS difficult. The option that is routinely used for corneal visual rehabilitation, keratoplasty, is best avoided in such cases. We describe the management strategies that are most effective during the acute and chronic stages of SJS. Although treatments for acute SJS involve immunosuppressive and immunomodulatory therapies, amniotic membrane transplantation is also useful. The options for visual rehabilitation in patients with chronic SJS are undergoing radical change. We describe the existing literature regarding the management of SJS and highlight recent advances in the management of this disorder.
authors.affiliation: Cornea, Ocular Surface and Anterior Segment Services, Department of Ophthalmology, drishtiCONE Eye Care, New Delhi, India.
authors.forename: Rajat
authors.initials: R
authors.lastname: Jain
authors.affiliation: Cornea and Refractive Surgery Services, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Cornea and Anterior Segment Services, Department of Ophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Sayan
authors.initials: S
authors.lastname: Basu
authors.affiliation: C J Shah Cornea Services, Department of Ophthalmology, Dr. G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Sankara Nethralaya, Chennai, India.
authors.forename: Geetha
authors.initials: G
authors.lastname: Iyer
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Ophthalmology, Doshisha University, Kyotanabe, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ueta
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Sotozono
authors.affiliation: Department of Ophthalmology, Kallam Anji Reddy Molecular Genetics Laboratory, L V Prasad Eye Institute (LVPEI), Hyderabad, Telangana, India.
authors.forename: Chitra
authors.initials: C
authors.lastname: Kannabiran
authors.affiliation: Cornea Services, Department of Ophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Varsha M
authors.initials: VM
authors.lastname: Rathi
authors.affiliation: Department of Ophthalmology, Dr. Shroff Charity Eye Hospital, Delhi, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
authors.affiliation: Cornea and External Disease Service, Department of Ophthalmology, Federal University of Sao Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil; Advanced Ocular Surface Center (CASO), Department of Ophthalmology, Federal University of Sao Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil.
authors.forename: José A P
authors.initials: JA
authors.lastname: Gomes
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: James
authors.initials: J
authors.lastname: Chodosh
authors.affiliation: Department of Ophthalmology, Srujana Center for Innovation, L V Prasad Eye Institute, Hyderabad, Telangana, India. Electronic address: vsangwan@lvpei.org.
authors.forename: Virender S
authors.initials: VS
authors.lastname: Sangwan
mesh_terms: D016039:Corneal Transplantation / Q000379:methods*; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D000072163:Ophthalmologists; D010819:Physician's Role; D033581:Stem Cell Transplantation / Q000379:methods*; D013262:Stevens-Johnson Syndrome / Q000150:complications* / Q000175:diagnosis; D014792:Visual Acuity
keywords: Stevens-Johnson syndrome; acute; dry eye; keratoprosthesis; stem cell transplantation: PROSE