PMC

Grading scale of conjunctival injection score ranged from 0 to 2 points (Grade 0 = none, Grade 1 = mild/moderate injection, Grade 2 = severe injection).

Grading scale of corneal fluorescein staining score ranged from 0 to 3 points (Grade 0 = no staining, Grade 1 = minimal staining, Grade 2 = mild/moderate staining, Grade 3 = severe staining).

(A) A representative biomicroscopic image of fluorescein staining (Severity score 3) is shown. Note diffuse punctate epitheliopathy on the cornea of a patient with chronic GVHD related dry eye. Gray lines (Meibolines on upper and lower lid margin) are distorted. (B) Note severe conjunctival injection on damaged ocular surface. (Severity score 2. (C) Note Rose Bengal staining of conjunctiva on severely damaged ocular surface.

(A) Typical histological findings of lacrimal gland focusing on medium sized duct and from a patient of chronic GVHD for diagnostic purpose and clinical findings around ductal orfices of meibomian and Zeiss gland in the lid margin of a 21-year-old male patient with chronic GVHD. CD45 immunostaining of inflammatory cells in lacrimal gland from a chronic GVHD patient. An abundant CD45⁺ inflammatory cell infiltration at periductal areas of lacrimal gland chronic GVHD. A 39-year-old female patient at 2 months after onset of cGVHD related dry eye. Original magnification: X630. (B) Note total obstruction of meibomian gland and Zeis gland orifices and severely fibrotic tarsal conjunctiva. Upper eye lid, right eye. A 21-year-old male suffering from chronic GVHD.