Early Symblepharon Associated With Periocular Cosmetic Use in a Young Woman With Chronic Dry Eye Disease: A Case...

Chronic dry eye disease (DED) is increasingly observed in younger individuals and is often associated with modifiable lifestyle factors. We report the case of a 27-year-old woman presenting with persistent ocular irritation, redness, and foreign-body sensation unresponsive to prior topical therapy. Clinical evaluation revealed mild conjunctival hyperemia and a localized inferonasal adhesion between the bulbar and tarsal conjunctiva in the right eye, consistent with early symblepharon formation. The findings were suggestive of evaporative DED exacerbated by habitual periocular cosmetic use and prolonged digital screen exposure. Management included discontinuation of cosmetic products, initiation of preservative-free lubricants, topical anti-inflammatory therapy, and implementation of eyelid hygiene and environmental modifications. At two-week follow-up, the patient demonstrated marked symptomatic improvement, with reduced ocular discomfort and no progression of the conjunctival adhesion. This case points out the possible role of chronic cosmetic exposure as an underrecognized contributor to ocular surface inflammation, tear film instability, and early conjunctival scarring. Early identification of modifiable risk factors and timely intervention are essential to prevent progression and preserve long-term ocular surface integrity.