The objective of the study was to evaluate the frequency and clinical characteristics of ocular complications and their risk factors, as well as autologous serum tears (AST) for the treatment of dry eye in these patients. Data from the files of 124 patients who had undergone allogeneic haematopoietic progenitor cell transplantation (HPCT) were evaluated. In addition, 33 HPCT patients were examined and their data were compared with controls. Analysis of tears and AST was performed. Dry eye manifestation occurred in 32% of patients and was positively correlated with age over 27 years (P ¼ 0.05), peripheral blood progenitor cell transplant (P ¼ 0.002), chronic graft-versus-host disease (P ¼ 0.0027), and chronic or acute myeloid leukaemia (P ¼ 0.001). Dry mouth and Schirmer test o5 mm were predictive factors for dry eye in HPCT patients (P ¼ 0.002 and odds ratio 3.9 and P ¼ 0.007, odds ratio ¼ 5.9, respectively). Microbiological analysis revealed that six of 11 AST samples were contaminated after 30 days of use. The present study supports the role of potential risk factors for ocular complications and key elements to detect alterations in the tear film from HPCT patients. In addition, AST contamination must be considered after longer periods of use.

ABSTRACT.Purpose: Dry eye in children is not common in general practice and is usually referred to tertiary centres for diagnostic confirmation. In the present review we examine the potential causes of dry eye in children and report the management and longterm follow-up of dry eye in childhood with reference to clinical diversity, systemic associations, ocular outcomes and treatment trends. Methods: A retrospective, consecutive case series was studied by evaluating the clinical charts of children with dry eye over a 96-month period. Minimal diagnostic inclusion criteria were presence of ocular surface damage and tear deficiency. Results: Fourteen patients with an age range at presentation of 1)17 years were evaluated. Ten patients were female, four were male and all had bilateral involvement. The most frequent symptoms were red eye, photophobia and low visual acuity (VA). Four patients had corneal ulcers. Two patients had best corrected visual acuity (BCVA) £ 20 ⁄ 200 at first examination. One of these plus another patient presented with BCVA £ 20 ⁄ 200 at the last visit. All patients were treated with artificial tears; three received autologous serum tears and five submitted to conjunctival flaps to preserve the integrity of the eye. Associated systemic conditions were found in all patients and were congenital in six of them. Conclusions: Early manifestations of dry eye in childhood are a potential indication of systemic disease. The ocular condition may be misdiagnosed and correct treatment delayed. Most diseases are bilateral and may jeopardize VA. Systemic investigation, close follow-up and preparing the family for longterm and multidisciplinary treatment are necessary to preserve ocular health and identify systemic associations.

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