Immune reaction and fibroinflammatory processes are characteristic features of chronic ocular graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). Ocular GVHD is a major complication that can affect the recipients’ quality of vision and activity of daily living after successful HSCT and can lead to a vision-threatening condition. We presented two cases of ocular GVHD who developed progressive ocular surface fibrosis including symblepharon, tarsal conjunctival fibrosis, fornix shortening, corneal limbal stem cell deficiency, conjunctivalization, neovascularization, eyelid hypervasclarization and meibomian gland dysfunction. Notably, despite the resolution of systemic GVHD, ocular GVHD continued to progress over the long term in both cases, resulting in decreased functional visual acuity, quality of vision and quality of life. We discussed potential causes for the persistence and progression of ocular GVHD during the absence of active systemic chronic GVHD. One possibility is that limbal stem cell damage occurring in the early stages of GVHD sets the foundation for ongoing and irreversible ocular surface fibrosis. Ocular GVHD may progress either rapidly or slowly over years, leading to permanent ocular surface damage.