BACKGROUND Since it's first description in 1974 by Kristensen and Norn numerous substances have been reported as potential causes for drug-induced pseudopemphigoid. The signs and symptoms are as severe as with ocular cicatricial pemphigoid. It seems to be most important for the visual outcome for how long the inducing drug was applied and how soon it has been stopped after the first signs. PATIENTS Six female patients were investigated. All six patients presented the clinical picture of a cicatricial pemphigoid but this was not confirmed by immunostaining. The average age of these patients was 72.5 +/- 8.1 years. In 5 of these patients topical antiglaucomatous drugs are thought to be the inducing factor. The average interval from the start of medication until the appearance of the first symptoms was 14.8 +/- 5.3 years. CONCLUSIONS. The drug-induced ocular pseudopemphigoid is a serious but rare consequence of long-term topical medication. This potential risk should be carefully balanced against the benefit of long-term topical therapy.