Pemphigoids

About Pemphigoids

Ocular cicatricial pemphigoid is caused by a rare systemic autoimmune disorder that primarily attacks the conjunctiva of the eye. The conjunctiva is the thin mucous membrane that covers the inner eyelid and sclera (white of the eye), which is very important in lubricating and protecting the eye. When the conjunctiva is attacked, inflammation (conjunctivitis), infection, and scarring results. If ocular cicatricle pemphigoid progresses without treatment, it can lead to blindness.

Risk Factors

Twice as many women as men are affected by this disorder and it typically occurs between the ages of 60 to 80 years old, with a few rare cases in younger adult. It also has a genetic component.

Causes

Common causes include:

• Myopia neurotrophic keratopathy
• Ocular injury
• Burns from cooking splashes or appliances or from fire
• Chemical burns from bleach or ammonia or lab chemicals or cleaning products.
• Radiation

Symptoms

Early symptoms include:

• Conjunctivitis (inflammation of the inner eyelid sclera)
• Burning
• Irritation
• Tearing with possible mucus discharge from the eye and trichiasis - eyelashes that turn inward.

Advanced symptoms can include blistering and scarring of the conjunctiva, symblepharon- adhesion of the conjunctiva to the eye, damage to structures that lubricate the eye, and scarring of the cornea.

Diagnosis

Ocular cicatricial pemphigoid can sometimes be difficult to diagnose because it can resemble other possible causes, such as side effects from medication, trauma, infection, and other systemic diseases such as sarcoidosis. Immunofluorescence and visual inspection of the eye for clinical symptoms are the most typical method of examination. Most cases are diagnosed with a biopsy performed of the conjunctiva; however, because it stems from a systemic disease, a complete patient history is also critical for a correct diagnosis. Examination of the skin and mucous membranes of the body may show other areas of the body affected, such as ulcers in the mouth or throat. Blood tests are often performed to check for antibodies.

Treatments We Offer

Systemic management is necessary to successfully treat pemphigoid. Topical medicines are often used in addition to systemic therapy. Treatments can include immunosuppressant, antibiotics, and corticosteroids. Eye drops and punctal plugs can also relieve symptoms by providing more lubrication in the eye to treat the dryness. Many cases will improve and go into remission with medical intervention, but routine monitoring of the condition by an eye doctor is important to ensure the disease progression does not lead to loss of vision.

Why Choose Columbia?

Columbia ophthalmologists do not want you to suffer. We provide accurate, comprehensive, and compassionate care with years of experience behind us to make sure you are diagnosed correctly and promptly.