The patient is a 34-year-old male who presents with bilateral ocular pain and burning. He is noted to have excessive tearing and continuous eye rubbing. He comments that his eyes itch persistently and that both eyes feel as if there is something in them. Scaly plaques and crust are visible along the top and bottom eyelid.
View the picture taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.