GVHD Case
Help your patients start seeing the world again.
I’m an ophthalmologist specializing in corneal and ocular surface diseases.
Patient case:
Female patient had leukemia and then a bone marrow transplant in 2018. Ten months after her bone marrow transplant, she developed ocular GvHD. Patient has extreme dry and painful eyes, photophobia, areas of punctate keratopathy, and difficulty in opening the eyes in the morning because of dried mucoid secretions.
Her ocular GvHD is causing severe damage to her ocular surface. Patient’s oncologist referred her to me for care.
Treatment Path:
My goal was to reduce her symptoms and provide pain relief and improve the health of the ocular surface. Lubrication is often the first step as is reducing tear evaporation, tear drainage, or ocular surface inflammation.
- To decrease tear evaporation, I instructed her to start using warm compresses and avoiding low humidity.
- I prescribed her with dry eye drops to see if we could reduce the immediate pain she was experiencing. I prescribed the drops for use as needed. She reported she was using the drops every 10 minutes.
- To decrease tear loss and drainage from the surface of the eye, I used temporary occlusion of the puncta.
- I then prescribed a topical corticosteroid to treat her inflammation to stimulate her meibomian glands.
- After 2 years, I was out of options. I referred her to a BostonSight PROSE Network Provider.
- I will continue to follow up with her regularly, and she will see her PROSE Provider annually for checkups. I remain her primary eye care provider, but I work in tandem with her PROSE provider to ensure her ocular issues are well-managed.
“She tells me after PROSE treatment, ‘I can’t live without my PROSE devices. Now I can see everything again, especially the joy on my children’s faces.’ As a doctor, this is the outcome I want for my patients.”
How is PROSE Different From a Scleral Lens?
While scleral lenses can help many patients, their customization capabilities are limited in comparison to PROSE treatment. PROSE uses fully custom prosthetic scleral devices ranging from 14mm to 23mm and allows the PROSE Fellow far more flexibility in its design versus traditional scleral lenses.
And PROSE is more than just a scleral lens – it is a comprehensive medical treatment delivered by specially trained PROSE Fellows in collaboration with corneal specialist ophthalmologists, working in partnership with your other medical providers to ensure treatment manages your underlying condition. There are fewer than 25 PROSE Fellows in the world. PROSE is available at top-ranked academic medical centers and clinics in the U.S. and Canada, as well as globally. Learn more about PROSE treatment here.
97% of patients with ocular complications from GVHD reported improved eye health, vision, and quality of life with PROSE treatment by BostonSight.
2024 BostonSight Survey of 2,000 PROSE patients
Patients wearing PROSE devices and scleral lenses reported improvement in dryness, eye pain, and quality of life.
Clinical Ophthalmology. 2021 Dec; 15: 4829-4838.