PMC9604402_01
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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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). 
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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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).