Ocular cicatricial pemphigoid

QUESTION 13

A 70-year-old man presents to an ophthalmology clinic with soreness and bilateral eye burning. He has noticed a foreign body sensation and increased crusting around the eyes in the morning. His past medical history is notable only for hypertension. He states that his symptoms began approximately 4 months ago and have worsened over time. On examination, he has an adhesion between the bulbar and palpebral conjunctival surfaces in both lower eyelids (13a, b). He does not have any other skin lesions.