Graft-versus-host disease and dry eye

Graft-versus-host disease (GVHD) is an important problem of hematopoietic stem cell transplantation. Dry eye disease (DED) is one of the most common complications of ocular GVHD, and patients experience symptoms such as blurred vision, pho-tophobia, sand stinging, pain, burning, and redness. DED can progress to keratopathy, ulceration, and visual loss if treatment is delayed or appropriate treatment cannot be arranged. Treatment of people with GVHD needs a multidisciplinary approach to ensure early diagnosis and to recognize all clinical signs of GVHD and to define disorder category and severity. The aim of the treatment is to improve the quality and quantity of tears, to protect the corneal epithelial integrity, and to reduce the inflammation on the ocular surface to reduce the severity of the symptoms and prevent their progression. In conclusion, patients with GVHD should be evaluated ophthalmologically very carefully, especially the condition of the ocular surface and the findings of DED before and after transplantation, and it is important to carry out ophthalmological examinations and follow-up of these patients at regular intervals. Thus, early diagnosis, prevention of possible complication, and correct planning of treatment, when necessary, are very important before serious, perhaps permanent, and life-threatening conse-quences are experienced.