Ocular Mucous Membrane Pemphigoid

(Cicatricial Pemphigoid; Ocular Cicatricial Pemphigoid; Benign Mucous Membrane Pemphigoid)

ByZeba A. Syed, MD, Wills Eye Hospital
Reviewed/Revised Apr 2023
VIEW PROFESSIONAL VERSION

Ocular mucous membrane pemphigoid is an autoimmune disorder that scars the conjunctiva and cornea.

  • The eyes become red, then the conjunctiva scars, eyelashes turn inward, and the cornea becomes clouded, blocking vision.

  • The diagnosis is suspected based on symptoms and the results of an eye examination and is usually confirmed by a biopsy of the conjunctiva.

(See also Overview of Conjunctival and Scleral Disorders and Mucous Membrane Pemphigoid.)

Ocular mucous membrane pemphigoid is an autoimmune disorder (a malfunction of the body's immune system that causes the body to attack its own tissues). It causes inflammation that begins in the conjunctiva (the membrane that lines the eyelid and covers the white of the eye). This disorder can also affect other mucous membranes of the body.

An Inside Look at the Eye

Symptoms of Ocular Mucous Membrane Pemphigoid

In people with ocular mucous membrane pemphigoid, both eyes are affected, becoming red at first. Later, the conjunctiva shrinks, making it difficult to pull the upper or lower eyelid away from the eye. Much later, the eyes become dry.

The cornea (the clear layer in front of the iris and pupil) can become cloudy, preventing light from reaching the retina and decreasing vision.

The conjunctiva can scar and shrink, causing eyelashes to turn inward (see Trichiasis) and further damage the cornea.

Diagnosis of Ocular Mucous Membrane Pemphigoid

  • A doctor's evaluation of symptoms

  • An eye examination

  • A biopsy of the conjunctiva

Doctors usually suspect the diagnosis of ocular mucous membrane pemphigoid based on the person's symptoms and the results of an eye examination, including an examination with a slit lamp (an instrument that enables a doctor to examine the eye under high magnification). The diagnosis is usually confirmed by a conjunctival biopsy. In this type of biopsy, a sample of the conjunctiva is removed and examined under a microscope.

Treatment of Ocular Mucous Membrane Pemphigoid

  • Artificial tears

  • Removal of lashes

  • Sometimes medications

Drugs Mentioned In This Article
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