Synechiae (Eye)

What are synechiae of the eye?

Synechiae (the plural of synechia) are adhesions between tissues in your eye, meaning the tissue sticks together in places where it shouldn’t. It occurs when your iris (colored part of your eye that contains your pupil) sticks to the clear tissue in front of or behind it. It can create pressure in your eye and lead to vision issues. Ocular synechiae is another name for this condition.

A synechiae diagnosis can be scary. But the good news is that there are effective treatments for synechiae. It’s important to catch the condition as early as possible, so contact a healthcare provider if you notice any changes in your vision or how your eye looks or feels.

Types of ocular synechiae

There are two types of ocular (eye) synechiae:

• Posterior synechiae:Your iris sticks to your lens, which is the transparent tissue behind your iris. Your lenses help your eyes focus light so you can see clearly. Posterior synechiae are the most common type of ocular synechiae.
• Anterior synechiae:Your iris sticks to your cornea, which is the clear covering on the front of your eye. Your cornea protects your eye and focuses light.

Who gets eye synechiae?

You’re at a higher risk of developing ocular synechiae if you have:

• An eye disease that causes inflammation, such as uveitis or iritis (iris inflammation).
• An eye injury.
• Cataracts.
• Eye surgery.

What causes eye synechiae?

Synechiae of the eye are usually the result of inflammation or injury in your eye. Scar tissue can cause your iris to stick to the layers of tissue in front of or behind it. Sometimes, synechiae are congenital, meaning they’re present at birth.

What are the symptoms of ocular synechiae?

Symptoms of ocular synechiae may include:

• Changes to the size or shape of your pupil or iris, such as miosis (small pupils) or mydriasis (large pupils).
• Eye pain, aching or irritation.
• Eye redness.
• Sensitivity to light.
• Vision loss.
• Watery eyes.

What are the potential complications of ocular synechiae?

Glaucoma (optic nerve damage due to pressure inside your eye) is ocular synechiae’s most serious side effect. Glaucoma can cause permanent vision loss or blindness if it isn’t treated.

Ocular synechiae affect how a clear fluid called aqueous humor moves from the front to the back of your eye. The fluid provides protection and nutrition to your eye. It also regulates the pressure in your eye.

Ocular synechiae can block the aqueous humor and prevent it from flowing through your eye as it should. This fluid buildup can increase the pressure in your eye (intraocular pressure), damage your optic nerve and lead to glaucoma.

What type of healthcare provider diagnoses eye synechiae?

Eye care specialists diagnose and treat issues that affect your eyes and vision. You’ll probably see an ophthalmologist, optometrist or both for synechiae.

How are eye synechiae diagnosed?

Your healthcare provider does an eye exam to diagnose synechiae. Your eye exam may include:

• Visual acuity test with reading charts to check for vision loss.
• Visual field test to check your ability to see things off to the side (peripheral vision).
• Eye pressure check (tonometry) and other glaucoma tests.
• Slit-lamp exam to look at the back of your eye with a special microscope.
• Optical coherence tomography to get detailed images of the back of your eye.

How are ocular synechiae treated?

Treatment for ocular synechiae depends on your symptoms and the severity of the condition. Your care plan may include:

• Mydriatic eye drops: Mydriatic eye drops dilate (enlarge) your pupils. They also relax muscles in your iris. These eye drops may help separate your iris from your lens or cornea.
• Corticosteroids:Corticosteroids are medications that reduce inflammation and may help break apart scar tissue in your eye. Your provider may recommend steroid eye drops, ointments, pills, injections or intravenous (IV) infusions.
• Glaucoma medication:Certain eye drops and medications, such as beta-blockers and prostaglandins, reduce fluid buildup and pressure in your eye. These medications may help prevent permanent optic nerve damage and vision loss.
• Surgery: If you have glaucoma caused by severe synechiae, you may need surgery. An eye surgeon uses a laser or makes an incision (cut) in your eye to drain fluid and reduce intraocular pressure. Surgeons can treat synechiae during cataract surgery.

Can I prevent eye synechiae?

Talk to your healthcare provider about the risk of eye synechiae if you have an eye disease such as uveitis. Your provider may prescribe eye drops or medications to reduce inflammation and scar tissue formation, which may prevent synechiae.

What’s the outlook for someone with ocular synechiae?

Synechiae doesn’t usually cause vision loss if it’s caught, diagnosed and treated early. But left untreated, severe synechiae can lead to permanent eye damage and vision loss.

What questions should I ask my doctor about eye synechiae?

• Can my iris heal on its own without treatment?
• If I need eye surgery, what steps can I take to prevent eye synechiae?
• What are the chances that eye synechiae will lead to glaucoma?
• What are the signs of eye synechiae getting worse?
• Will eye synechiae get worse over time?

A note from Cleveland Clinic

Eye synechiae occur when your iris adheres to your lens or cornea. It results from scar tissue from eye trauma, inflammation or surgery. In severe cases, synechiae can lead to glaucoma and permanent vision loss. While any condition affecting your eyes and vision can be scary, there’s a variety of effective treatments for eye synechiae.

Talk to your healthcare provider if you’re experiencing vision changes or eye problems. They can refer you to an eye care specialist who can diagnose your condition and build an appropriate care plan. Eye synechiae are usually treatable with eye drops, medication or surgery.