Miscellaneous Eyelid Conditions
OCULAR CICATRICIAL PEMPHIGOID
Ocular cicatricial pemphigoid (OCP) is a conjunctival scarring disease that occurs in older adults. It can be mild or progressive and can lead to corneal scarring and blindness. OCP continues to be a confusing, poorly understood condition that can be very difficult to treat in some patients.
Epidemiology and Etiology
• Age: Older adults
• Gender: More common in females
• Etiology: An autoimmune process in which antibodies bind to the conjunctival basement membranes, resulting in inflammation and scarring
History
• There may be a long history of ocular irritation and epilation of eyelashes over many years. The other extreme is rapidly progressive conjunctival and even corneal scarring with very red inflamed eyes.
• Some patients will have ulceration of other mucosal surfaces such as oral, esophageal, or genital lesions.
• Skin lesions may also be part of the presentation.
• A significant number of these patients have used or are currently using antiglaucoma drops.
Examination
• Findings range from mild, subtle conjunctival scarring in the early stages to severe scarring where the eyelid is stuck to the cornea.
• Cicatricial entropion, trichiasis, and severe dryness all add to the poor ocular surface. The condition of the cornea is important in guiding treatment.
• Presence of tears versus very dry eyes is important to note. Very dry eyes have a much poorer prognosis.
• Evaluation of the mouth and skin for other lesions is important (Fig. 7-1).
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
