case_images: PMC9604402_01
case_images: Slit lamp photographs at presentation. (A) Dense punctate epithelial erosions are seen after fluorescein staining of the patient's right eye along with a couple of trichiatic lashes. (B) Total limbal stem cell deficiency with complete corneal conjunctivalization and symblepharon formation is seen in the patient's left eye.
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case_images: Severe conjunctival injection and ocular surface dryness was present in both eyes (Figure 1A), while the cornea of the left eye was completely conjunctivalized (Figure 1B). 
case_images: Photographs of the patient's right eye 8 months after initiation of aggressive immunosuppressive therapy. (A) External photograph of the patient's right eye shows symblepharon formation and forniceal foreshortening without conjunctival injection. (B) A dense nuclear and posterior subcapsular cataract has formed. The patient's vision dropped to 20/200 and her intraocular pressure rose to 35 mmHg while on oral and topical steroids.
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case_images: At the 8 month follow up visit the ocular surface was white and quiet (Figure 2A) but the cataract had matured significantly with a nuclear sclerotic and a posterior subcapsular component (Figure 2B).