Download ocular surface manifestations of the toxic epidermal

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E. Langwinska-Wosko, J. Szaflik, A.M. Ambroziak, M. Korwin
Department of Ophthalmology Medical University of Warsaw, Warsaw, Poland
Aim: The purpose of the study was to present 3 cases of toxic epidermal necrolysis and its’ ocular manifestations in
patients treated in the Department of Ophthalmology Medical University of Warsaw.
Material: We present 3 cases (2 females, 1 male) of TEN in patients treated due to ocular manifestations of that
First one is 23-years old female patient, in whom first symptoms of TEN occurred following administration of 1 tablet
of Aspirin at the age of 11. Second one is a 23-years old female with TEN incidence following Augmentin
administration. Third case is a 39-years old male patient, who had first symptoms of the disease 7 years ago
following oral administration of antibiotic.
Results: First patient was first admitted to due to acute severe bilateral keratoconjunctivitis with extensive
symblepharon formation. We observed symblepharon formation and complete corneal neovascularization. Patient
underwent corneal limbal grafting in 2003.
Second patient was admitted with right orbital tissues vasculitis, endophthalimits and corneal ulceration. We had to
perform penetrating corneal grafting.
The third individual presented bilateral obstructive cicatrical meibomian gland dysfunction, symblepharon formation,
and severe dry eye syndrome.
Conclusions: Recent literature as well as our own experience in the areas of ophthalmology and dermatology
illustrate that the ophthalmologist’s role should no longer be considered secondary in the acute management of TEN.
Amniotic membrane transplantation and intravenous corticosteroid pulse therapy at the acute stage shown promise
for preventing late sight-threatening cicatrical complications.