In exposed patients with tearing and blurring of vision, serum IgM levels were significantly lower than matched controls (P = 0.026 and 0.027, respectively). Serum IgM levels in exposed patients with normal ocular conditions were significantly lower (P < 0.050) than that of matched controls. Serum levels of IgA, IgE and IgG and IgG3 levels were not significantly different between the two groups with abnormal and normal ocular conditions. Mean serum IgG1 levels in exposed patients with normal ocular conditions were significantly higher than the matched controls (P < 0.05) except for tearing and photophobia. Mean serum IgG2 levels in exposed with blurring of vision and without tearing, ocular pain, photophobia, lids and bulbar conjuctival abnormalities were significantly higher than that of matched controls (P < 0.050). Mean serum levels of IgG4 in exposed patients with normal ocular conditions and most of the abnormal ocular conditions were significantly lower than the matched controls (P < 0.05). The results of the current study showed that even 20 years after SM exposure serum immunoglobulins are different from matched normal controls and the levels of IgM and IgG4 are associated with some aspects of ocular surface problems.