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To report the clinical findings of a case of Stevens-Johnson syndrome (SJS) precipitated by the use of systemic doxycycline.Case report.A 49-year-old man developed SJS with ocular involvement after doxycycline use for respiratory symptoms. The patient developed persistent 2+ conjunctival injection and foreshortening of the conjunctival fornices in both eyes. The right eye had a 3 × 3.4 mm corneal epithelial defect with 50% thinning. The left eye had a 2.6 × 3 mm corneal ulcer with a central perforation and a flat anterior chamber with 360 degrees of iridocorneal touch.This case illustrates the unusual presentation of SJS induced by doxycycline. The prevalent use of systemic doxycycline in the practice of ophthalmology for eyelid-related and ocular surface disorders coupled with the detrimental long-term sequelae of SJS renders a careful reevaluation for alternatives.