Which disease involves scarring of mucous membranes and can progress to severe ocular surface disease?

• A. Ocular Rosacea
• B. Allergic conjunctivitis
• C. Ocular Cicatricial Pemphigoid
• D. Meibomian gland dysfunction

Answer: (C)

Scarring of mucous membranes with potential progression to severe ocular surface disease points to an autoimmune blistering condition that targets mucous membranes, including the conjunctiva. In this disease, antibodies attack components of the basement membrane, leading to subepithelial blistering and progressive cicatrization of the conjunctiva. As scarring advances, the fornices shorten, adhesions (symblepharon) can form, and the tear reservoir is compromised, which can result in chronic dry eye and exposure-related damage to the cornea. Early detection is important because the cicatrization can be ongoing and cause significant vision loss if not treated.

Other conditions listed cause ocular surface inflammation or tear-film instability but do not typically produce mucous membrane scarring of the conjunctiva. Ocular rosacea can involve the eyelids and glands but not conjunctival cicatrization; allergic conjunctivitis causes itching and redness without mucous membrane scarring; meibomian gland dysfunction affects the lipid tear layer but does not scar the conjunctival mucosa.