The differential diagnosis for pseudomembranes or membranes most commonly includes severe viral or bacterial conjunctivitis, Stevens Johnson syndrome, and chemical burns. Less common are ligneous conjunctivitis, ocular cicatricial pemphigoid, and superior limbic keratoconjunctivitis. Ligneous conjunctivitis can be distinguished from other causes of pseudomembranes because of its thicker, more homogenous appearance, and by patient history as it is more common in infants than are other causes of membranes such as ocular cicatricial pemphigoid. Pseudomembranes can be differentiated from membranes on peeling: the presence of blood after peeling favors the diagnosis of a true membrane.
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