Vernal keratoconjunctivitis

A chronic allergic eye disease

Vernal keratoconjunctivitis (VKC) is a chronic, bilateral inflammation of the conjunctiva and cornea. It is a recurrent condition that typically affects children and young adults, particularly males, and is more prevalent in warm, dry climates.

Signs and symptoms

Vernal keratoconjunctivitis is characterized by intense itching, photophobia, tearing, and a thick, ropy discharge. Patients often experience a burning sensation and a feeling of grittiness in the eyes. The condition is seasonal, with symptoms worsening in the spring and summer months.

Pathophysiology

VKC is an allergic condition mediated by immunoglobulin E (IgE) and involves a hypersensitivity reaction. The conjunctiva becomes inflamed due to the release of inflammatory mediators from mast cells. This leads to the characteristic symptoms of itching and redness.

Diagnosis

Diagnosis of VKC is primarily clinical, based on the patient's history and symptoms. Slit-lamp examination may reveal giant papillae on the upper tarsal conjunctiva and limbal infiltrates. Corneal involvement can lead to the formation of shield ulcers.

Treatment

Management of VKC involves avoiding allergens and using medications to control symptoms. Topical antihistamines and mast cell stabilizers are commonly prescribed. In severe cases, topical corticosteroids may be necessary, but their use is limited due to potential side effects. Immunomodulatory agents such as cyclosporine can also be effective.

Prognosis

The prognosis for VKC is generally good, with most patients experiencing a reduction in symptoms as they age. However, chronic inflammation can lead to complications such as corneal scarring and vision loss if not properly managed.

Epidemiology

VKC is more common in males and typically presents in children and young adults. It is more prevalent in regions with warm, dry climates, such as the Mediterranean, Africa, and the Middle East.

Related pages

• Allergic conjunctivitis
• Atopic keratoconjunctivitis
• Giant papillary conjunctivitis

References

A patient with vernal keratoconjunctivitis showing characteristic symptoms.