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JAMA Ophthalmology Clinical Challenge
August 2017

Conjunctival Lesion in a Patient With Ocular Graft-vs-Host Disease

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, Washington University in St Louis, St Louis, Missouri
  • 2Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois
JAMA Ophthalmol. 2017;135(8):883-884. doi:10.1001/jamaophthalmol.2016.5483

A 67-year-old man presented with intermittent ocular irritation, discharge, and blurry vision in his left eye. He had a history of chronic lymphocytic leukemia for which he had received allogeneic bone marrow transplantation; his course was complicated by extensive graft-vs-host disease including ocular manifestations. His graft-vs-host disease was treated with systemic tacrolimus. He also had a history of herpes simplex keratitis with fungal infection in the right eye that led to corneal perforation requiring penetrating keratoplasty. His best-corrected visual acuities were 20/125 OD and 20/60 OS.

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