Indian Journal of Ophthalmology

: 2003  |  Volume : 51  |  Issue : 4  |  Page : 361-

Ocular cicatricial pemphigoid: All conjunctival scarring is not trachoma

S Varughese, N Gupta 

Correspondence Address:
S Varughese

How to cite this article:
Varughese S, Gupta N. Ocular cicatricial pemphigoid: All conjunctival scarring is not trachoma.Indian J Ophthalmol 2003;51:361-361

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Varughese S, Gupta N. Ocular cicatricial pemphigoid: All conjunctival scarring is not trachoma. Indian J Ophthalmol [serial online] 2003 [cited 2024 Feb 27 ];51:361-361
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Dear Editor,

Ocular cicatricial pemphigoid (OCP) can be easily mistaken for trachoma in tropical countries. Ten cases of paediatric OCP have been documented in the literature.[1] We report here two cases of which one developed OCP at 11 years of age.

A 36-year-old male had a 4-year history of recurrent irritation and redness of both eyes. Thickened upper lids, trichiatic lashes, foreshortened fornices, and early symblepharon formation was seen in both eyes. A conjunctival biopsy was positive for immunoflourescence for IgG and C3. Three months after starting Dapsone, his conjunctival erythema had improved.

A 14-year-old girl presented with irritation and redness of the left eye of 3 years duration. There was no history of drug reaction. She had filamentary keratitis, punctate epithelial erosions, and also shortening of the inferior fornix with early symblepharon formation [Figure 1]. Medial cathal keratinisation was absent. Conjunctival biopsy was positive for IgG and negative for C3. She was started on Dapsone after excluding G6PD deficiency. Her irritation and redness reduced. Her tear film improved. She has been follow up for 3 years.

The pathogenesis of OCP is deposition of antigen-antibody complexes in the epithelial basement membrane.[2] Diagnosis is confirmed by direct immunoflourescence.[3] Dapsone 50mg once daily is suggested for mild to moderate inflammation. Immunosuppressive agents like cyclophosphamide, methotrexate and cyclosporin A, as also intravenous immunoglobulin therapy and subconjunctival mitomycin have been tried.[2] Local management of secondary eyelid and conjunctival abnormalities is essential.


1Iglesias LS Quismono FP Jr, Mc Donnell PJ, Barnes C. Ocular cicatrical pemphigoid in a 12 year old boy. Cornea 1992;2:365-67.
2Donnenfeld ED, Perry HD, Wallerstein A, Caronia RM, Kanellopoulous AJ, Sforza PD, et al. Subconjunctival mitomycin C for the treatment of ocular cicatrical pemphigoid. Ophthalmology 1999;106:72-78.
3Holsclaw DS. Ocular cicatrical pemphigoid. International Ophthalmic clinics 1988;38:89-106.