A CLINICAL STUDY ON ACUTE OPHTHALMIC MANIFESTATION AND MANAGEMENT OF STEVENSJOHNSON SYNDROME CONDUCTED AT A TERTIARY CENTRE OF THIRUVANANTHAPURAM, KERALA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 19
Abstract
BACKGROUND SJS (Stevens-Johnson Syndrome) is an acute life-threatening immune complex mediated hypersensitivity reaction to drugs that results in extensive necrosis and detachment of the epidermis, which shows widespread lesions affecting mouth, eyes, pharynx, larynx, skin, genitals etc. Acute ocular manifestation caused by SJS causes severe ocular morbidities if not treated at an early stage. MATERIALS AND METHODS A descriptive follow-up study was undertaken at Regional Institute of Ophthalmology (RIO), Thiruvananthapuram, Southern Kerala. Patients presented at Dermatology and General Medicine Department of Medical College Hospital, Thiruvananthapuram, identified with SJS were examined and called for detailed ocular evaluation at RIO. A total of 52 cases were screened during August 2009 to 2011 and all patients were told about the severity of disease and their detailed drug history, personal history and ocular symptoms were collected. Protocol based treatments were offered to all subjects and effect of treatment was studied during follow-up periods. Data of the patients was recorded on a prefabricated proforma. Data was statistically analysed to find out association and comparison between different parameters using non-parametric Chi-square (χ2) test. RESULTS 23.1% of SJS subjects showed toxicity to ciprofloxacin; 96.2% showed acute ophthalmic manifestation. Catarrhal type of conjunctivitis was the commonest, which responds well to terramycin eye ointment and frequent irrigation of eyes. Corneal erosions and corneal ulceration in the acute period were reduced in the follow-up period due to active ophthalmic intervention in the early period. CONCLUSION 1. SJS is a life-threatening illness with high incidence of ocular involvement. 2. Conjunctivitis is the commonest acute ophthalmic manifestation. 3. Early interference and active treatment regimen can reduce the events and further extent of corneal involvement.
Authors and Affiliations
Rema Devi S, Ajith Chakravarthy
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