Abstract

SYNOPSIS: An elderly male came with a 3 week history of redness, watering in both eyes not relieved with anti-histamines and antibiotics. He gave a past history of cataract surgery in both eyes, using anti-glaucoma eye drops since then and repeated episodes of similar complaints. His BCVA was 6/18 OD and 6/24 OS, intraocular pressure was normal. There was conjunctival congestion with sub tarsal scarring, trichiasis, entropion and symblepharon, cornea had bilateral diffuse punctate epithelial erosions, rest of the findings were normal. With a differential diagnosis of ocular cicatricial pemphigoid and pseudo pemphigoid, all the topical medications were stopped and he was prescribed preservative free lubricants. ANA testing confirmed our diagnosis. The patient was started on immunosuppressants, topical and oral steroids. After remission, he underwent a conjunctival- sparing upper lid entropion surgery and his vision improved to 6/9 OU. Ocular surface remained stable for three months.