Have you ever felt like your eyelids are stuck together when you open your eyes? Or that it's hard to move your eyes? Sometimes it may seem like it's not a big deal. But, this is something we really need to pay attention to, and it can be a bit serious. Today we're going to talk about something like this, which in medical terms is called Symblepharon.
What exactly is Symblepharon?
Simply put, a symblepharon is a adhesion of two membranes inside our eye. Now you may be wondering what these membranes are. The white part of our eye (doctors call it the sclera) is covered by a very thin, transparent membrane . Also, the inside of our eyelids is also covered by a similar membrane. We call both of these membranes the conjunctiva. So, if for some reason these two membranes stick together, that is what we call a symblepharon.
Imagine that there is a severe inflammation inside our eye. Then the tissues inside the eye swell and start sticking together. After this inflammation heals, scar tissue forms in those stuck areas. That is when this adhesion becomes permanent. Sometimes, not just in one place, but in several places, such adhesions can occur. If there is persistent eye inflammation, this condition of symblepharon is likely to occur again and again.
What are the symptoms of this condition? How do you recognize it?
Most of the time, you can see this symblepharon when you look at your eye. It looks like a band of tissue that connects the inside of the eyelid to the eyeball . If you can't see it directly, you may feel something like this:
- It feels like you can't open your eyelids completely.
- It's becoming difficult to turn your eyes in all directions like before.
In addition to these main symptoms, other side effects may occur. Let's see what they are:
- `Ptosis`: This is when the eyelid droops downward due to the symblepharon, making it look as if the eye is closed .
- Entropion: This is when the eyelid turns inward due to symblepharon, causing the eyelid to roll into the eye . This can be very uncomfortable.
- `Lagophthalmos`: This is when the eyelid cannot be completely closed due to symblepharon. It looks as if the eye is half open.
- `Diplopia`: Due to the limitation of eye movement, vision begins to be divided into two . This is the perception of two images instead of one.
These side effects can cause further eye discomfort. For example:
- Redness of the eyes.
- Sensitivity to light (difficulty seeing in sunlight, bright lights).
- Tears flowing from the eyes.
- Dry eye.
Imagine that your friend Nimal got a chemical in his eye when he was a child and got injured. After that, the membrane inside his eye became stuck and he couldn't open it properly. His eye hurts and itches all the time. That could be due to Symblepharon.
Why does this symblepharon develop? What are the causes?
As I mentioned earlier, the main cause of Symblepharon is a severe or long-term inflammation of the conjunctiva, known as conjunctivitis (which is what we usually call "eye infection"). This inflammation causes the tissues to swell and stick together. Later, scars form and the adhesions become permanent.
Sometimes, not only the `(Conjunctiva)`, but also the transparent membrane covering the black eye, that is, the `(Cornea)`, can become inflamed. Then we call it `(Keratoconjunctivitis)`. In such a situation, adhesions can also form between the `(Conjunctiva)` and the `(Cornea)`.
There are several causes that can cause severe `(Conjunctivitis)` or `(Keratoconjunctivitis)`:
- Infections:
- Ocular herpes (herpes infection of the eye)
- `Trachoma` (a bacterial infection - this is now rare in Sri Lanka, but is still a serious problem in some countries)
- Adenoviral keratoconjunctivitis (a serious eye disease caused by a virus)
- Injuries:
- Chemical burns: If a harsh chemical like acid or base gets in the eye. You need to be careful when using household cleaning products.
- Complications of eye surgery .
- Adverse reactions to some eye medications .
- Autoimmune diseases: These are diseases in which our body's own defense system, our own cells, attacks us. Examples:
- ``Ocular cicatricial pemphigoid''
- `Mucous membrane pemphigoid`
- Stevens-Johnson syndrome (a severe allergic reaction to certain medications)
- `Lichen planus`
- `Scleroderma`
There are many reasons for this. The most important thing is to not ignore an eye infection and seek medical advice.
Can Symblepharon cause serious complications?
Yes, sometimes symblepharon can cause serious problems.
- There are many eye problems that can occur. For example, an ingrown eyelash (trichiasis) can be very painful.
- If a symblepharon develops in the conjunctiva fornix, where the eyelid and eyeball meet deeply, our tear system can become blocked . Then the tears start to pool instead of draining properly.
- If the movement of the eyeball is restricted, or if the symblepharon sticks to the cornea, that is, the black eye, there is a possibility of vision loss .
That is why we need to be concerned about this situation.
How do doctors diagnose this?
Your ophthalmologist (or eye care provider) can diagnose symblepharon during a routine eye exam. Before the exam, they may prescribe eye drops to help relieve eye discomfort.
During the examination, the doctor will carefully examine exactly what tissue is attached and where it is attached . They will also check for other complications that may occur with the type of symblepharon you have.
Sometimes, if the cause of symblepharon is not known, your doctor may suggest further tests. For example, an eye swab or blood test may be done. While some causes can be completely cured with treatment, others may be chronic conditions that persist and require ongoing treatment.
What are the treatments for Symblepharon?
In fact, it is easier to prevent symblepharon before it develops than to treat it after it has developed . If your doctor knows that you are at increased risk of developing this type of adhesion, or that you have another condition that can cause this condition, they will try to prevent it. They do this by helping to keep the two surfaces of the conjunctiva from sticking together during the inflammation of the eye while treating your underlying condition.
Medical treatment
The following may be given as treatment for your underlying condition:
- Reduce inflammation with `Corticosteroids` type medications.
- If there are infections, they are treated with antibiotics or antivirals .
- If it is a disease of the immune system, it is treated with `Immunomodulators` (medicines that control the immune system) .
This medication can be given as a pill or as eye drops. After the inflammation has subsided, the doctor may cover the eye with a special membrane called an `amniotic membrane` to prevent or reduce scarring. This may be a disc that is placed on the eye, similar to a `contact lens`, or in some cases, the eye may be connected surgically.
Symblepharon surgery `(Symblepharon surgery)`
If your doctor can't prevent a symblepharon from forming, or if you are being treated after it has formed, you may need to have surgery to remove the adhesions.
The complexity of symblepharon surgery depends on its severity. Sometimes a simple procedure can be done. However, sometimes, a complex `Oculoplastic surgery` (plastic surgery involving the eye and surrounding tissues) may be required. Some of the techniques used in these surgeries are:
- `Symblepharon release`: This involves separating the adhesions between the `(Conjunctiva)` membranes. Sometimes, the scar tissue in the `(Conjunctiva)` also has to be removed.
- Tissue graft: Tissue can be taken from another part of the eyeball, or from another mucous membrane, such as the inside of the lip, to replace the tissue that the surgeon removed from the eye.
- Oculoplastic reconstruction: If your symblepharon has affected the conjunctiva fornix, the surgeon will need to reconstruct it. If the cornea, or cornea, has been affected, a keratoplasty may be performed.
What is the outlook for the future with this situation? `(Prognosis)`
Your prognosis depends on several factors, including how severe your condition is, how much eye tissue is affected, and how you respond to treatment.
Some cases heal completely. But sometimes, permanent damage can occur . For some people with chronic conditions, this condition may recur, gradually increasing the scarring.
How can I prevent the development of Symblepharon?
If you have severe conjunctivitis, an eye infection that doesn't seem to be getting better, you should definitely see a doctor . Severe conjunctivitis can cause redness, swelling, and pain in the eye. Most common, minor eye infections will resolve on their own. However, severe cases may require medical attention to prevent complications such as symblepharon.
Most of the time, symblepharon can be asymptomatic. Your doctor may find it when you go for a routine eye exam. If you don't have any symptoms, it's unlikely to cause any serious damage. The most important thing is to find out what's causing your symblepharon and prevent further damage.
Take-Home Message
Okay, so now you have a better understanding of the Symblepharon we talked about today. Remember:
- Symblepharon is a adhesion of the membranes inside the eye .
- The main cause of this is severe or long-term eye inflammation (conjunctivitis) .
- Symptoms may include inability to open the eyelid properly, difficulty turning the eyeball, and double vision.
- Prevention is best . If you develop eye inflammation, seek medical advice immediately.
- Treatment includes medication for the underlying disease and surgery if necessary.
- Don't be afraid of this, but don't ignore it either. If you have these symptoms, definitely see an eye doctor. Then you can start the necessary treatment as soon as possible.
Protecting your eyes is very important, right? That's why it's so important to be aware of things like this.
` Symblepharon, Symblepharon, Eye diseases, Conjunctivitis, Eye inflammation, Eye surgery, Eyesight
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