Purpose

To describe the diagnostic confirmation rates, treatment pathways, and long-term ocular and surgical outcomes of OCP cases managed by the oculoplastics and cornea services of a tertiary referral centre in the UK.

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Methods

Retrospective case series of patients with clinically diagnosed ocular cicatricial pemphigoid/ocular mucous membrane pemphigoid managed at Leicester Royal Infirmary. Demographics, staging of conjunctival cicatrisation, biopsy/direct immunofluorescence (DIF) results, systemic immunosuppression, relapses, complications, and oculoplastic/corneal interventions were extracted with a follow-up of up to 7 years.

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Results

21 patients were included (mean age 74 years; range 41–87), 13 of whom (61.9%) had biopsy confirmation. Patients were managed jointly by the cornea and oculoplastics services, frequently presenting with lid malposition requiring entropion repair. Most achieved clinical disease control using systemic corticosteroids with mycophenolate mofetil as the principal steroid-sparing agent; escalation beyond MMF was uncommon. Over follow-up, visual acuity, cicatrisation progression, relapse frequency, ocular surface complications, and surgical outcomes are reported.

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Conclusion

In our tertiary cohort with long follow-up, conjunctival & buccal mucosa biopsies confirmed the presence of disease in approximately two-thirds of clinically suspected OCP, consistent with known limitations reported in the literature. A corticosteroid-to-MMF pathway provided durable control for most patients, supporting MMF as an effective steroid-sparing option in real-world practice. Joint cornea–oculoplastics management is critical for timing and outcomes of entropion repair, as well as ocular surface and vision preservation.

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Additional Authors

First name	Last name	Base Hospital / Institution
Anastasia	Gkiala	University Hospitals of Leicester
Mario Frank	Farrugia	University Hospitals of Leicester
Navpreet	Dhillon	University Hospitals of Leicester
Antonella	Berry-Brincat	University Hospitals of Leicester

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