Ocular complications after liver transplantation: A comprehensive review of infectious and non-infectious etiologies

Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure. With advances in surgical techniques and immunosuppressive regimens, patient survival rates have significantly improved. While the systemic complications of post-transplantation are well recognized, ophthalmic manifestations remain underreported. Ophthalmic complications can significantly impair visual function and increase morbidity in these patients. Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus, Candida, Aspergillus, etc. Other common findings include dry eye disease, cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients. Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes. High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment. This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.