Symblepharon is an adhesion between the conjunctiva of the lid and the eyeball resulting from injuries.

Burns from lime or acids are the usual causes. Other causes include: pemphigus (see diagnostic code: 7815 bullous disorders); trachoma (see diagnostic code: 6017 conjunctivitis, trachomatous, chronic); or following operations. This condition occurs as a result of interference with the movement of the eyeball and conjunctival irritation.

Manifestations of the condition include: scarring of the conjunctiva; adherence of the eyelids to the eyeball; keratitis (see diagnostic code: 6001 keratopathy); and closure of the orifices of the accessory and main lacrimal glands. Pain, photophobia, and tearing may also accompany this condition.

Eye examinations may include: external examination; visual acuity; visual fields; ophthalmoscopy, and slit lamp.

Initial treatment is not very effective as attempts are directed at separating the raw surfaces. Relief of adhesions and protection of the cornea and conjunctiva with a large soft contact lens may be done. Grafts of mucous membrane from the mouth or conjunctiva may be needed to replace scarred conjunctiva.

Treatments may fail, and there will be scarring of the conjunctiva and cornea.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Consider entitlement to specially adapted housing under 38 U.S.C. 2101(a)(2)(A)(i) if there is visual impairment to the degree specified in 38 CFR 3.809(b)(2).

• The veteran, spouse, surviving spouse or parent will be considered in need of regular aid and attendance if he or she is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less (38 CFR 3.351(c)(1)).

• Consider entitlement to automobile allowance and/or automobile adaptive equipment if there is visual impairment to the degree specified in 38 CFR 3.808(b)(3).

• Review for entitlement to special monthly compensation under 38 CFR 3.350.

• For the purposes of evaluation under 38 CFR 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes

• Examples of treatment may include but are not limited to: Systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions

• For the purposes of evaluating visual impairment due to the particular condition, refer to 38 CFR 4.75, 38 CFR 4.76, 38 CFR 4.77, 38 CFR 4.78,  and  38 CFR 4.79, diagnostic codes 6061-6091.