Management
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Graft-versus-Host Disease (GVHD)
Î For ocular GVHD, aggressive lubrication and punctal occlusion
are particularly useful in treating patients with secondary
keratoconjunctivitis sicca. (III, I, D)
Î There may be some role for topical corticosteroids in treating
conjunctival hyperemia. (III, I, D)
Î Topical cyclosporine or autologous serum tears can be used to treat
dry eye syndrome associated with GVHD. (II-, I, D)
Î In more severe cases, surgical excision of pseudomembranous tissue
has been advocated over conservative therapy. (III, I, D)
Î Other secondary complications of ocular GVHD such as cicatricial
eyelid malposition, SLK, or limbal stem cell failure should be managed
on a case-by-case basis. (III, I, D)
Î For vision correction and relief from dry eye symptoms in these
patients, scleral lenses may be helpful. (III, I, D)
Sebaceous Carcinoma
Î When a diagnosis of sebaceous carcinoma is confirmed by an eyelid
biopsy, local excision is indicated. (III, I, D)
Î The excision should be performed by a surgeon experienced in the
treatment of eyelid tumors, and adjunctive therapy should be used as
needed for any residual pagetoid component. (III, I, D)
Ocular Surface Squamous Neoplasia
Î When a diagnosis of ocular surface squamous neoplasia is confirmed
by biopsy, treatment may consist of local excision with or without
chemotherapeutics. (III, I, D)
Î Topical chemotherapeutics alone may completely resolve the
malignancy. (III, I, D)
Î Management should be conducted by an experienced specialist.
(III, I, D)
Î Anterior segment OCT may be a tool facilitating follow-up for patients
with ocular surface squamous neoplasia. (III, I, D)
