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BACKGROUND:In this case report we describe a very rare case of symblepheron which hasn't been reported in literature till date, triggered by long standing cilia embedded in the subconjuctival space followed by regression of symblepheron by removing the cilia. CASE REPORT: A 65-year-old man, presented to the eye O.P.D of I.G.M.C. Shimla with complaints of irritation and foreign body sensation in the left eye from last 8-9 months. He had no history of trauma, chemical injury or surgery in left eye in the past. He had history of multiple treatments with topical antibiotics and lubricants for the complaints with no relief. Torch light examination revealed a whitish membrane in the lower palpebral conjunctiva. Slit lamp examination revealed two semilunar pseudopockets and partial symblepheron in lower fornix. Further probing revealed two eyelashes embedded in the subconjuctival space in one of the peudopockets. Search with a needle under topical anesthesia under slit lamp magnification enabled the cilia to be removed with little difficulty; the cilia were of the same size and appearance as the patient's own. He was prescribed topical antibiotics and the symblepheron regressed significantly in 8 weeks' time. CONCLUSION: Long term inflammation associated with foreign bodies like embedded cilium in the subconjuctival space may cause unusual presentations like symblepheron as in this case.

BACKGROUND:Posterior embryotoxon is a congenital anomaly, considered to be a relatively mild disorder and can occur in 15% of normal eyes. Bilateral posterior embryotoxon associated with maxillary hypoplasia, Ventricular Septal Defect (VSD), Pulmonary Atresia (PA) with Patent Ductus Arteriosus (PDA) is of rare occurrence and hasn't been reported in literature till date. CASE: We report a case of 12 year old female who came to us in eye Out Patient Department for routine eye checkup and on detailed ocular examination we found anteriorly displaced Schwalbe's line. On detailed physical examination and investigations she was found to have pan-systolic murmur and continuous machinery murmur. On Echocardiography, the patient was found to have large perimembranous VSD with PA and PDA. On Oro-dental examination she was found to have maxillary hypoplasia. CONCLUSION: The present case is reported due to the rarity and sporadic character of the condition and its rare association with cardiac defect and maxillary hypoplasia.

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