Ocular surface rehabilitation efforts may be appropriate in a variety of circumstances, either with relatively limited goals, such as stabilization of the ocular surface or improved patient comfort, or with grander goals, such as improvement of vision. But failure to identify the cause of the ocular surface problem in the first place, and failure to eliminate that cause before proceeding with attempts at ocular surface rehabilitation virtually guarantees failure to achieve the desired goal. The first two, most essential elements in the quest toward ocular surface rehabilitation are (a) to identify the cause of the ocular surface pathologic process, and (b) to eliminate that cause so that it will not continue to produce the pathologic process. For example, it has been obvious to all ophthalmologists for approximately four decades that corneal transplantation, in an effort to rehabilitate the ocular surface in a patient who has had corneal scarring and neovascularization as a consequence of active ocular cicatricial pemphigoid, is the height of folly, because failure to control the underlying cause of the ocular surface disorder (active pemphigoid) ensures that the new cornea will be damaged by the same inflammatory process that damaged the patient’s original cornea.