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Stevens-johnson treatment options

Steven’s-Johnson is a rare, but very serious disease. Stevens-Johnson Syndrome (also known as SJS) is unpredictable and can happen to anyone. It is caused by a reaction to a medication or infection. It starts off with flu like symptoms, but then spreads throughout the body in the form of a painful rash and blisters. Mucous membranes are affected, which is why eye doctors become involved.

SJS is a serious condition which requires hospitalization. After being released from the hospital, the patient usually works with a team of doctors to manage different parts of their body.

SJS patients usually have extremely dry eyes, inflamed eyes, and severe eye pain. Many patients wear very dark sunglasses indoors and outdooors. Often times, the pain is so bad, they keep their eyes closed the entire day and night. Their quality of life can be very poor.

We are fortunate to work with some of these special patients.

A 79 year old female arrived at the office last week for a consultation. She had SJS 30 years ago, and still suffers from a variety of issues. Regarding her eyes, she stated her eyes were incredibly painful all the time. She has to put preservative free artificial tears in her eyes every few minutes, around the clock! Her eyes are red, swollen, and highly sensitive to light.

You can see in the photo that her eyes are very swollen. She wears dark sunglasses all the time due to her severe light sensitivity. She keeps her eyes closed majority of the day because they hurt when she opens them.

For these types of patients, I highly recommend the EyePrint Prosthetic. This is due to the fact that we only have a very small eyelid fissure to work with. For SJS patients, they can’t keep their eyes open even for a few seconds, so it makes fitting their eyes very difficult.

By taking an impression of the surface of the entire eye, the lab is able to design a specialized custom lens. This is the best option for SJS patients, in our opinion.

We were able to take multiple impressions of each eye and send those to the lab to be fabricated.

She arrived to our office for the dispense and we inserted the lenses for her. She was thrilled with the vision and the comfort of her eyes. She wore them over the weekend and when we saw her for her follow up, she said, “You’ve given me a new lease on life!”

You can see in the photo that her eyes are much less swollen and much less red when she has the lenses in her eye. This is because the scleral lens is filled with a preservative free saline, that bathes her eye all day. This also forms a protective barrier between her delicate eye and the outside environment. Scleral lenses can be life changing for these patients. We are honored to work with these special patients - we love seeing their eyes heal and get another chance on life!

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