This video addresses the diagnosis and medical treatment of ocular cicatricial pemphigoid (OCP), a systemic, autoimmune disease in the spectrum of mucous membrane pemphigoid with preferential involvement of the conjunctiva, producing chronic conjunctivitis with eventual subepithelial fibrosis, progressive scarring, keratopathy, and loss of vision. It is a rare systemic disease that can lead to blindness if not diagnosed and treated with with systemic therapy. OCP can be confirmed only by using immunohistochemistry on a conjunctiva biopsy.