Symblepharon is a pathological condition where the bulbar and palpebral conjunctiva form an abnormal adhesion to one another. This condition can be acquired due to a number of inflammatory or traumatic etiologies. Immune-mediated inflammatory conditions include Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis, ocular cicatricial pemphigoid, and mucous membrane pemphigoid. Traumatic causes include chemical burns, thermal burns, and mechanical trauma.


There are many causes of symblepharon, which is typically a response to trauma or inflammation.  In no particular order, here are some of those causes:

  • Ocular cicatricial pemphigoid
  • Pseudopemphigoid conditions
  • Stevens-Johnson syndrome
  • Trauma
  • Conjunctival burns
  • Atopic keratoconjunctivitis
  • Porphyria cutanea tarda
  • Rosacea
  • Epidemic keratoconjunctivitis
  • Xeroderma pigmentosum
  • Squamous papilloma of the conjunctiva


  • Ocular motility disorders
  • Diplopia
  • Entropion
  • Inadequate lids closure
  • Signs: adhesion between bulbar and palpebral conjunctiva

May occur as a complication of various ocular diseases such as: dry eye syndrome, Stevens-Johnson syndrome, cicatricial pemphigoid, chemical injury, erythema multiforme, pemphigus bullosa or as a complication of chemical burn.

Any conjunctival infections complicated with conjunctival scaring may cause symblepharon; chlamydial conjunctivitis, vernal, atopic, bacterial conjunctivitis and epidemic keratoconjunctivitis.


The diagnosis of symblepharon involves a thorough eye examination, including a slit-lamp examination to evaluate the extent of the adhesion. The ophthalmologist may also perform a Schirmer test to evaluate tear production and a fluorescein staining test to evaluate the cornea.

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