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Table 16. Ocular Late Effects

Predisposing Therapy Ocular/Vision Effects Health Screening/Interventions 
GVHD = graft-versus-host disease.
Busulfan; corticosteroids; radiation impacting the eyeCataractsHistory: decreased acuity, halos, diplopia
Eye exam: visual acuity, funduscopy
Ophthalmology consultation
Radiation impacting the eye, including radioiodine (I-131)Ocular toxicity (orbital hypoplasia, lacrimal duct atrophy, xerophthalmia [keratoconjunctivitis sicca], keratitis, telangiectasias, retinopathy, optic chiasm neuropathy, enophthalmos, chronic painful eye, maculopathy, papillopathy, glaucoma)History: visual changes (decreased acuity, halos, diplopia), dry eye, persistent eye irritation, excessive tearing, light sensitivity, poor night vision, painful eye
Eye exam: visual acuity, funduscopy
Ophthalmology consultation
Hematopoietic cell transplantation with any history of chronic GVHDXerophthalmia (keratoconjunctivitis sicca)History: dry eye (burning, itching, foreign body sensation, inflammation)
Eye exam: visual acuity, funduscopy
EnucleationImpaired cosmesis; poor prosthetic fit; orbital hypoplasiaOcular prosthetic evaluation
Ophthalmology