Ophthalmological perspectives of toxic epidermal necrolysis

Ophthalmological perspectives of toxic epidermal necrolysis: Gayatree Mohanty, Shovna Dash, Manoj Kumar, Devanshi Desai



Archives of Medicine and Health Sciences 2019 7(2):254-257



Toxic epidermal necrolysis (TEN) is as rare as two cases per million per year, but the ocular manifestations and sequelae are very severe. We present a case series of seven patients admitted to the intensive care unit in a tertiary hospital with a diagnosis of TEN describing the extent of ocular involvement, its response to treatment, and appearance of sequelae. All seven were drug-induced with moderate-to-severe skin, mucosal, ophthalmic involvement, and systemic involvement. Ocular findings on presentation were eyelid skin detachment, adherent lid margins, bilateral mucopurulent conjunctivitis with inflammatory membranes, and punctate epithelial keratitis in all patients. Large persistent corneal epithelial defect was seen in four patients. On follow-up, five had severe keratoconjunctivitis sicca and entropion with trichiasis. Photophobia was the major debilitating sequelae. Early management was the key to reduce severity, cicatrization, and sequelae. Corticosteroids topically and systemically, topical cyclosporine, and lubricants were the mainstay of management.