Ocular Cicatricial Pemphigoid Clinical Presentation and Complications

Clinical Presentation

• The American Academy of Ophthalmology notes that ocular cicatricial pemphigoid (OCP) is characterized by bilateral conjunctival injection and papillary conjunctivitis, often with asymmetric presentation 1, 2
• OCP can present with keratitis and eyelid thickening, accompanied by meibomian gland dysfunction 1
• The disease is marked by progressive conjunctival scarring, beginning in the fornices, with subepithelial fibrosis and keratinization 1, 2

Differential Diagnosis and Complications

• The American Academy of Ophthalmology recommends considering alternative diagnoses, such as bacterial conjunctivitis, preseptal or orbital cellulitis, or Stevens-Johnson syndrome/TEN, in cases of massive eye swelling or periorbital abscess 1, 3, 4
• Bacterial conjunctivitis, particularly gonococcal, can cause marked eyelid edema and severe hyperpurulent discharge 3
• Stevens-Johnson syndrome/TEN can cause acute bilateral conjunctival inflammation with membranes 1, 4