Symblepharon involves fusing of the eyelid to an opposing surface, such as the tarsal and bulbar conjunctiva.

1. Physical trauma with denuded epithelium, including purulent, membranous, bullous, or ulcerative conjunctivitis and trauma
*2. Chemical bums-especially lime or caustic bums
*3. Inflammation-especially from drug reactions, including:

allobarbital amobarbital aprobarbital auranofin aurothioglucose aurothioglycanide barbital benzalkonium butabarbital butalbital butallylonal butethal carbachol (?) clonidine (?) colloidal silver cyclobarbital demecarium diethylpropanediol (DEP) dipiperidinoethane (DPE) dipivefrin echothiophate epinephrine F3T

gold Au 198 gold sodium thiomalate gold sodium thiosulfate heptabarbital hexethal hexobarbital idoxuridine idoxuridine (IDU) isoflurophate mephobarbital metharbital methitural methohexital mild silver protein mitomycin oxyphenbutazone penicillamine pentobarbital phenobarbital phenylbutazone pilocarpine primidone probarbital secobarbital silver nitrate

silver protein sulfacetamide sulfachlorpyridazine sulfacytine sulfadiazine sulfadimethoxine sulfamerazine sulfameter sulfamethazine sulfamethizole sulfamethoxazole sulfamethoxypyridazine sulfanilamide sulfaphenazole sulfapyridine sulfasalazine sulfathiazole sulfisoxazole talbutal (?) thiamylal thiopental (?) timolol trifluridine vidarabine vinbarbital (?)

4. Long-standing acute inflammation

 A. Pemphigus (Cazenave disease)
 B. Stevens-Johnson disease (dermatostomatitis)

5. Congenital
6. Associated with cyanoacrylate tissue adhesive
7. Epidemic keratoconjunctivitis

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.

Leahey AB, Gottsch JD. Symblepharon associated with cyanoacrylate tissue adhesive. Am J Ophthalmol 1993; 115: 46-49.

Meyer SJ, et al. Conjunctival involvement in paraneoplastic pemphigus. Am J Ophthalmol 1992; 114:621-624.