OcMMP is characterised by chronic cicatrising conjunctivitis that leads to ocular surface disease such as dry eye,
symblephara, corneal ulceration, trichiasis, entropion/ectropion and eventually vision loss. Documentation using
established grading methods have a critical role in providing accurate and objective assessments of disease severity
and progression. Several existing and proposed methods for grading OcMMP have been described in the literature,
each with their own limitations. The majority of the methods focused on grading disease severity and progression
using permanent damage parameters only. However, recent literature on the ocular surface has defined and
demonstrated the importance of having both activity and damage indices, providing a platform for the development of future grading methods. Further development of grading tools incorporating both activity and damage would facilitate more comprehensive assessments, allow comparison of clinical outcomes, and provide commonality for discussion of these patients due to the multidisciplinary nature of their care.

Methods for grading severity of ocular involvement in patients with mucous membrane pemphigoid.