Clinical Report: Ocular Cicatricial Pemphigoid Management with Scleral Lenses

Overview

This report evaluates the management of ocular cicatricial pemphigoid (OCP) using scleral lenses, highlighting significant improvements in ocular comfort and visual acuity. The findings suggest that early intervention with scleral lenses is a beneficial adjunctive therapy in OCP management.

Background

Ocular cicatricial pemphigoid is a chronic autoimmune disorder that can lead to severe ocular surface instability and visual impairment. The disease poses a significant risk to the limbal stem cell population, necessitating effective management strategies. Current treatment approaches often require a combination of systemic immunosuppression and ocular surface protection to mitigate symptoms and prevent disease progression.

Data Highlights

Key Findings

• All patients reported subjective improvement in ocular comfort after scleral lens fitting.
• Mean keratopathy grading improved significantly from 2.1 to 1.4.
• Mean visual acuity improved from 0.56 to 0.34 logMAR, with 46% of eyes gaining 2 or more lines of visual acuity.
• 96% of fitted eyes responded positively to treatment and continued successful scleral lens wear.
• Clinical signs such as fornix shortening and trichiasis remained stable in patients with these findings at baseline.

Clinical Implications

The findings support the use of scleral lenses as an effective strategy for managing ocular cicatricial pemphigoid, particularly during periods of disease quiescence. Clinicians should consider early intervention with scleral lenses to optimize ocular surface health and improve patient comfort.

Conclusion

Scleral lenses represent a valuable adjunctive therapy in the management of ocular cicatricial pemphigoid, demonstrating significant benefits in ocular comfort and visual outcomes. Early intervention is recommended to enhance patient care.

References

1. Barnett M, Contact Lens Spectrum, 2023 -- Ocular Cicatricial Pemphigoid Management with Scleral Lenses
2. Miller WL, Contact Lens Spectrum, 2013 -- Treatment Plan Managing Ocular Cicatricial Pemphigoid
3. DeNaeyer GW, Contact Lens Spectrum, 2021 -- CONTACT LENS CASE REPORTS Recommendations
4. Carmona ER, Contact Lens Spectrum, 2024 -- A Scleral Lens Solution to PCED and OSD Discomfort
5. European Guidelines (S3), 2021 -- Diagnosis and Management of Mucous Membrane Pemphigoid
6. Rituximab for the Management of an Australian Cohort of Treatment Refractory Mucous Membrane Pemphigoid, 2025
7. Contact Lens Spectrum — Fitting Scleral Lenses for Ocular Surface Disease
8. Scleral Lens Use in the Management of Ocular Cicatricial Pemphigoid
9. European Guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology – Part II - PMC
10. Rituximab for the Management of an Australian Cohort of Treatment Refractory Mucous Membrane Pemphigoid - PMC