Síndrome de Stevens-Johnson com envolvimento ocular: relato de caso.

Stevens-Johnson Syndrome (SJS) is a severe mucocutaneous reaction that can lead to chronic ophthalmological complications, compromising the ocular surface and visual prognosis. This paper aims to report the case of a patient with SJS and severe ocular involvement, followed up at an ophthalmological clinic. A 41-year-old male patient had a history of corneal transplantation in the right eye (OD) performed during adolescence. Subsequently, he underwent penetrating retransplantation, complicated by perforation, requiring tectonic transplantation. After a new perforation, corneal patch coverage was performed. Clinical evaluation identified graft thinning and bulging, 360° corneal neovascularization, and bilateral inferior temporal symblepharon. The OD progressed to phthisis bulbi. In the left eye, stromal opacities, keratitis, edema, and symblepharon were observed. Treatment included lubricants, topical antibiotics and corticosteroids, in addition to oral doxycycline. Although evisceration of the right eye (OD) was considered, preservation was chosen as long as the patch remained intact and asymptomatic. This case highlights the difficulty in managing ocular SJS, in which limbal insufficiency and chronic inflammation contribute to graft failure and recurrent perforations. It is concluded that these patients require multidisciplinary follow-up, rigorous inflammatory control, and individualized strategies to preserve ocular integrity and reduce complications.