REPORT OF A CASE
A 56-year-old white man, who had received a renal transplant and who was beleaguered by numerous actinic keratoses and verrucae, was noted on routine examination to have a bullous lesion on the right conjunctival surface. He was unaware of the lesion and had stated that it was totally asymptomatic. The patient denied any previous blistering disorders of skin or mucous membranes. His opthalmologic history revealed cataract extraction bilaterally and lens implantation with trabeculectomy performed approximately 6 years prior to presentation. He had also undergone a surgical procedure for glaucoma control. More recently, he had noted a diminution of vision bilaterally following a cerebral vascular accident. The patient's medications included prednisone and azathioprine (Imuran) taken daily following the successful renal transplantation 13 years previously. On physical examination, a tense bulla containing clear fluid was present on the conjunctiva at the 12-o'clock position superior to the iris (Fig