Symptoms and Signs of Ocular Mucous Membrane Pemphigoid Usually beginning as a chronic conjunctivitis with nonspecific hyperemia without discharge in certain quadrants, ocular mucous membrane pemphigoid progresses as follows: Subconjunctival fibrosis Conjunctival shrinkage with loss of the inferior fornix Symblephara (adhesions between the tarsal and bulbar conjunctiva) Keratoconjunctivitis sicca Trichiasis (in-turning eyelashes) Corneal epithelial defects and bacterial corneal infection Corneal neovascularization, opacification, keratinization, and blindness Oral mucous membrane involvement with ulceration and scarring is common, but skin involvement, characterized by scarring bullae and erythematous plaques, is uncommon.