Ocular graft-versus-host disease after allogeneic transplantation

Ocular graft-versus-host disease (GVHD) is a common complication that occurs after allogeneic transplantation. It can cause severe dry eyes that are described as having a burning, gritty, and painful sensation. Ocular GVHD can affect quality of life by causing pain and photophobia, limiting activities of daily living (e.g., reading, watching television), compromising safety while driving, and permanently damaging vision. Pre- and post-transplantation evaluations by an ophthalmologist are recommended. Routine assessments using the National Institutes of Health eye score should be administered to patients at each follow-up visit to their transplantation physician. Treatment options include lubricating eye drops, immunomodulator and steroid drops, and punctal occlusion. Relieving symptoms is difficult, and although multiple treatment options exist, many are ineffective. The Boston Foundation for Sight's scleral lens is an available option that promotes corneal healing and symptom relief. The current article discusses treatment options and supportive care measures for patients with ocular GVHD aimed at relieving symptoms and preventing complications.