Inclusion Criteria

- INCLUSION CRITERIA:

To be eligible for the study each participant must satisfy all of the following inclusion
criteria:

- Male or female greater than or equal to 9 years of age.

- Must be greater than or equal to 30 days post-hematopoietic stem cell transplantation
(SCT) and have systemic GVHD diagnosed by the transplant physician.

- Must have lacrimal gland dysfunction from GVHD following SCT as defined by Schirmer
tear test score (with anesthesia) of greater than or equal to 1 mm but less than or
equal to 9 mm in both eyes.

- Must have open puncta and no puncta plug placement at the time of enrollment.

- If using topical corticosteroids, must be equal dose in both eyes of less than or
equal to 4 drops per day.

- Topical lubrication using tear substitutes (includes eye drops, gels, and ointments)
are permitted with equal dosing in both eyes.

- Must understand and sign informed consent or assent.

- Must be willing and able to comply with study evaluation and testing schedule.

- Females of childbearing potential and all males must agree to use an effective form
of birth control for duration of the study.

- Females of childbearing potential must have a negative serum pregnancy test at
baseline evaluation.

EXCLUSION CRITERIA:

To be eligible for the study, participants must not satisfy any of the following exclusion
criteria.

- Use of a topical ophthalmic cyclosporine formulation less than or equal to 30 days
prior to enrollment.

- Diagnosed with active ocular infection.

- History of recurrent herpes keratitis or active disease less than or equal to 6
months prior to enrollment.

- Aqueous tear deficiency or KCS related to previous irradiation, Stevens-Johnson
syndrome, cicatricial pemphigoid, alkali burns, trachoma or Sjogren's syndrome.

- Seropositive for Hepatitis C (i.e. positive anti-HCV antibody) or seropositive for
HIV with testing performed no earlier than 4 months before the date of stem cell
transplantation.

- Diagnosis of active sarcoidosis.

- Use of a drug with anticholinergic activity within less than 4 times the half-life of
the drug prior to enrollment (e.g., carbamazepine [Tegretol (R)] has a half-life of
16-24 hours so must not be used within 4 days of enrollment).

- Use of an investigational drug for eye disease within 30 days of enrollment.

- Known allergy or hypersensitivity to cyclosporine, fluorescein, or lissamine green.

- Uncontrolled systemic disease or serious illness that could, in the investigator's
opinion, interfere with the participant's ability to comply with study therapy,
required follow-up testing, or interfere with interpretation of the study results.

- Pregnant or lactating female.

- Serum creatinine greater than 2.5 mg/dL, absolute neutrophil count (ANC) less than
750/MicroL Platelet count less than 25,000/MicroL, Partial Thromboplastin Time (PTT),
or International Normal Ratio (INR) or Prothrombin Time (PT) exceeding the
institutional upper limit of normal would require review by the Hematologist for
surgical clearance. Hematologist review of the abnormal coagulation value and
approval for surgery must be documented in the medical record prior to the surgical
procedure.

- Participants that have received total body irradiation or direct eye/orbital
radiation greater than 5000 cGy. (Potential participants will be assessed by a study
clinician to determine that the cause of the dry eye symptoms is due to GVHD and not
radiation. The clinician, in conjunction with the oncology staff as needed, will
also assess the participant's clinical exam and medical history).