Ocular complications in high-dose chemoradiotherapy and marrow transplantation

Patients who have received marrow transplants and total body irradiation with different forms of chemotherapy should be routinely watched by an ophthalmology service because of the high incidence of dry eye syndrome, viral keratitis, and trophic disturbances of the cornea. Herpes simplex keratitis must be strongly suspected in bizarre corneal findings associated with geographic epithelial denudement accompanying acute GVHD. Acute GVH ocular syndrome warrants clinical recognition when, in the course of severe GVHD, the eyes reveal keratoconjunctivitis with associated herpes simplex infections of the cornea, later to show chronic problems of severe drying conjunctival and corneal scarring compatible with Stevens-Johnson syndrome.