Nasolacrimal duct obstruction following allo-HSCT: an overlooked manifestation of ocular graft-versus-host disease

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for a broad spectrum of benign and malignant haematological disorders [ 1 ]. However, graft-versus-host disease (GVHD) remains a major long-term complication, with ocular involvement occurring in 40–60% of recipients [ 2 ]. Ocular GVHD typically affects the ocular surface system, and while it rarely causes permanent vision loss, it substantially impairs patients’ long-term quality of life. Nasolacrimal duct obstruction (NLDO) is an underrecognised manifestation of ocular GVHD, with only two isolated case reports in existing literature [ 3 , 4 ]. Evidence regarding the safety and efficacy of surgical management for NLDO in this immunocompromised population remains scarce, limiting standardised clinical decision-making.