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GVHD- graft-vs-host-disease | Risk Factors | Symptoms | Treatment

What is GVHD- graft-vs-host-disease?

Ocular Graft Versus Host Disease (GVHD) occurs in patients who have undergone allogenic hematological stem cell transplantation. It can occur in patients who have acute or chronic GVHD, though it is more common in patients with the chronic form. Approximately 40-90% of patients with chronic GVHD will develop ocular symptoms. Ocular manifestations can include: moderate to severe blurred vision that is not correctable with spectacles, keratoconjuncitvitis sicca(dry eyes), bilateral marginal keratitis, anterior uveitis, corneal ulceration, or neovascularization.

Risk Factors

Patients who have undergone allogenic stem cell transplantation are at risk for developing GVHD.


  • Blurred vision that is not corrected with spectacles
  • Dry, irritated eyes
  • Feeling gritty or painful
  • Tired eyes
  • Light sensitivity
  • Red eyes


Treatment for ocular GVHD is comparable to other severe types of dry eye. However, when the vision is compromised and spectacles will not correct the vision, large diameter (18.0mm and larger) scleral contact lenses are very successful and used often.

Topical steroids are used earlier for ocular GVHD than they would for other causes of dry eye. Cautious use and monitoring are warranted with use of topical steroids due to increased risk of steroid-related complications, such as elevated intraocular pressure, cataracts, and infectious keratitis.

As a patient recovers from GVHD complications, scleral contact lens use is often discontinued after an average use of 18 months and spectacles will provide adequate vision. Some patients require contact lens for life to provide good vision and dry eye symptomatic relief. GVHD patients experience such severe dry eyes that the contact lenses have to be removed and reinserted during the day to provide a “replenishment” of fluid held between the contact lens and the cornea.

Our doctors work closely with your oncologist to provide you with the best care and best vision possible. Please feel free to call our office at 214.739.8611 Ext 1 and speak to a member of our staff to answer any questions you may have. An office consultation is the best place to start to determine if you are good candidate for this remarkable treatment.