Breaking barriers: Safe anesthesia strategies for ocular surgery in Stevens-Johnson syndrome

Stevens-Johnson syndrome (SJS) is a rare but potentially fatal mucocutaneous hypersensitivity reaction, most often drug induced. Anesthetic management in patients with a history of SJS is particularly challenging due to the heightened risk of severe allergic or anaphylactoid reaction. We present the case of a 20-year-old male with a previous episode of SJS undergoing symblepharon correction under monitored anesthesia care. Given the patient’s extensive drug allergy history, subcutaneous sensitivity testing was performed preoperatively to assess potential hypersensitivity to commonly used anesthetic agents. A mild localized reaction was noted only with ondansetron. The surgical procedure was completed uneventfully under local anesthesia. This case illustrates the importance of individualized anesthetic planning and highlights the cautious use of subcutaneous sensitivity testing as a preoperative safety measure in high-risk patients.