Which finding is least associated with ocular cicatricial pemphigoid (OCP)?

• A. Symblepharon
• B. Blepharitis
• C. Ankyloblepharon
• D. Ocular surface disease

Answer: (B)

Ocular cicatricial pemphigoid causes progressive scarring of mucous membranes, so the eye shows changes driven by conjunctival fibrosis. The hallmark ocular changes are adhesion between the eyelid and globe (symblepharon) and, when eyelids fuse or shorten, ankyloblepharon. The scarring also shortens or obliterates the fornices and disrupts the tear film, leading to ocular surface disease such as keratopathy. Blepharitis is simply inflammation of the eyelid margin and is not a specific or defining feature of this cicatrizing process. It can occur for many reasons and does not reflect the conjunctival scarring that characterizes OCP, making it the least associated finding.