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Forty-four patients (21 male, 23 female) were studied following bone marrow transplantation (BMT): 40 after allogeneic, one after syngeneic and three after autologous transplantation. Diffuse punctate conjunctival and corneal epitheliopathy was seen in 27 (61%), reduced or disordered tear film in 26 (59%), acquired lacrimal outflow obstruction in three (7%) and posterior subcapsular lens opacities in five (1 2%) patients. Conjunctival histology showed abnormal features, including those of graft-versus-host disease (GVHD) in 41 patients. Of these, 28 (64%) had clinical and laboratory features of GVHD and six patients with no systemic evidence of GVHD had conjunctival histology specific for GVHD.We conclude that after BMT, subclinical changes of GVHD are very common in the periocular tissues and may be universal in long-term survivors following allogeneic BMT. Some minor conjunctival changes are more likely to be due to the primary disease or the transplant conditioning regimen. Conjunctival biopsy is useful in demonstrating low-grade GVHD or GVHD confined to the ocular structures and may be diagnostic in some cases.

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The results of argon laser trabeculoplasiy (ALT) in a series of 252 patients are presented with follow-up of up to five years. The procedure is effective in chronic open-angle glaucoma (COAG).The use of argon laser trabeculoplasty (ALT) in chronic glaucoma of various types is now well accepted following the pioneering work of Wise' and the coptributions of other ~o r k e r s .~-'~ The method is attractive because it is non-invasive, is performed on an outpatient basis and usually requires only topical anaesthesia. However, there have been conflicting reports on the efficacy of the method both in chronic simple open-angle glaucoma and in various forms of secondary glaucoma.We have used the method over a period of up to five years and this paper reviews our results with this procedure in a group of patients with different types of glaucoma. PATIENTS AND METHODSPatient examination included Goldmann applanation tonometry, slit lamp biomicroscopy, anterior chamber depth measurement using the Haag-Streit pachometer and gonioscopy. On gonioscopy the angle width, pigmentation, iris bowing, density and extent of iris processes, and presence of peripheral anterior synechiae were Reprint requests: Dr A. M. V. Brooks,