Impact of ocular graft-versus-host disease on visual quality of life in patients after allogeneic stem cell transplantation: questionnaire study.

PURPOSE: To determine the influence of ocular complications on quality of life (QoL) 3 years after allogeneic stem cell transplantation (allo-SCT). METHODS: All 54 adult patients that underwent and survived allo-SCT in 2006/2007 in our centre received two questionnaires (VFQ-25: visual function questionnaire-25 and OSDI: ocular surface disease index). In addition, the following data were included: gender, age, underlying disease, presence of chronic and/or ocular graft-versus-host disease (GVHD), number of visits to an ophthalmologist, manifestations of dry eye disease, the duration of follow-up and treatment for ocular GVHD. RESULTS: Ocular GVHD developed in 26% (14 of 54) of patients and 71% (10 of 14) received treatment for ocular GVHD. The presence of ocular GVHD correlated with the severity of systemic GVHD (correlation coefficient: 0.52, p = 0.00). The Karnofsky scores were significantly lower in the patients with ocular GVHD compared to the patients with no ocular GVHD (p = 0.001). Karnofsky scores were weakly correlated with the severity of systemic GVHD (correlation coefficient: 0.25, p = 0.03. Three years after the all-SCT, OSDI and VFQ-25 scores were significantly impaired in patients with ocular GVHD [mean: 76.5; range (46.1-100) and mean: 31.1; range (0-72.9)] compared to patients with no ocular GVHD [mean: 89.4; range (45.2-100) and mean: 12.9; range (0-58.3); p = 0.02]. The scores of the VFQ-25 were significantly lower in the domains of general health, ocular pain, social functioning and role difficulties. CONCLUSION: The long-term vision-related QoL measured by the OSDI and VFQ-25 was impaired in patients with ocular GVHD.

Ocular manifestations of transconjunctival heroin abuse: a case report of an unusual route of substance abuse.

PURPOSE: The purpose of this study was to present a patient with atypical corneoconjunctival lesions as a result of transconjunctival heroin abuse. METHODS: The authors conducted a prospective 8-month follow up of a 16-year-old girl who presented with bilateral atypical corneoconjunctival lesions. RESULTS: After a period of close observation, running diagnostic tests, and conservative treatment, the nature of the disease was suspected. Further discussion with the patient's family and her final confession revealed that she was using heroin through the conjunctiva. CONCLUSION: Substance abuse should be considered in the list of differential diagnoses in patients with an unusual presentation of ocular disease.

A case of ectopic cilia.

Ectopic cilia are the most rare of cilial anomalies. We report a 27-year-old man who presents with tarsal conjunctival symptomatic ectopic cilia. On slit-lamp examination eversion of the lower eyelid demonstrated that several black-white cilia were protruding from the conjunctiva.