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.
Artificial tears can be used, inwardly turned eyelashes can be removed, and some people require drugs that suppress the immune system.
(See also Overview of Conjunctival and Scleral Disorders Overview of Conjunctival and Scleral Disorders The conjunctiva is the membrane that lines the eyelid and loops back to cover the sclera (the tough white fiber layer covering the eye), right up to the edge of the cornea (the clear layer in... read more and Mucous Membrane Pemphigoid Mucous Membrane Pemphigoid Mucous membrane pemphigoid is an autoimmune disorder that causes blisters to form in the mucous membranes of the body. The mucous membranes most often affected are the mouth and eyes. Mucous... read more .)
Ocular mucous membrane pemphigoid is an autoimmune disorder Autoimmune Disorders An autoimmune disorder is a malfunction of the body's immune system that causes the body to attack its own tissues. What triggers an autoimmune disorder is not known. Symptoms vary depending... read more (a malfunction of the body's immune system Overview of the Immune System The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more 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
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 Trichiasis Trichiasis is misalignment of eyelashes, which rub against the eyeball, in a person who does not have entropion. Trichiasis develops most commonly some time after chronic blepharitis (inflammation... read more ) and further damage the cornea.
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 Slit-Lamp Examination A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2... read more (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.
Removal of lashes
People with ocular mucous membrane pemphigoid can use artificial tears and doctors can remove inwardly turned lashes (for example, by pulling, freezing, or burning with electricity) to help relieve symptoms and prevent some complications. If the disease progresses, a drug that suppresses the immune system, such as dapsone, methotrexate, mycophenolate mofetil, or cyclophosphamide, is needed.