The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Ocular cicatricial pemphigoid

Photo by Professor Chua Chung Nen

This 48 year-old fisherman developed bilateral recurrent conjunctivitis two years ago. He was on no medications. Examination revealed bilateral symblepharon, more obvious in the right than the left eye, and upper and lower eyelids entropions. There were obliterations of the caruncles and all the eyelids showed subtarsal fibrosis. However, there was no lesions on the buccal mucosa. The entropions were successfully treated with anterior lamellar repositioning and Weiss's procedure. The conjunctivitis was controlled with topical steroids given twice daily. The following pictures were taken when the eyes were relatively quiet.

 

Right lower lids symblepharon.

 

Obliteration of the right caruncle.

 

Right subtarsal fibrosis.

 

Left subtarsal fibrosis.

 

Obliteration of the left caruncle.

 

Shallowing of the left lower fornix.

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