Title: Study of Clinical Features and Management of Vernal Keratoconjunctivitis
Authors: Dr Prachee Nagrale, Dr K.Vijaykumar, Dr Nanda Nandan, Dr Sritha Vemuganti
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.86
Abstract
Introduction
Vernal Keratoconjunctivitis is a recurrent, bilateral interstitial inflammation of the conjunctiva, of periodic seasonal incidence, self limited character and unknown etiology. It is characterised by flat- topped papillae, usually on the tarsal conjunctiva resembling cobble stone in appearance, a gelatinous hypertrophy of limbal conjunctiva, either discrete or confluent and a distinctive type of keratitis. It is associated with itching, redness of eyes, lacrimation and a mucinous or lardaceous discharge usually containing eosinophils. The term ‘vernal’ is derived from the Greek meaning ‘occurring in the spring’. It has predilection for warm rather than cold climates with frequent family and personal history of atopic disease, a higher than 2:1 frequency in males over females, an early onset, with remission by the late teens and a hereditary predisposition with exogenous factors, such as climate, season, allergen exposure, determining the likelihood and severity of this. The pathogenesis of VKC is probably multifactorial. The histopathologic and immunopathologic characteristics of the tissues had led some authorities to conclude that VKC is not a pure type 1 Gell and Coombs hypersensitivity reaction, but rather a combination of both type 1 and type 4 reactions.The predominant symptom of VKC is profound itching. Other symptoms are excessive tearing, mucus production, photophobia and burning and foreign body sensation. The classic sign of palpebral VKC is giant papillae or cobblestone in upper tarsal conjunctiva. Inflammation of bulbar conjunctiva is variable, but a ropy, lardaceous thread almost invariably can be found in inferior fornix1. Keratitis and shield ulcers are sight threatening complications.2 There is an association of keratoconus in VKC patients.3 Other risks are of cataract and glaucoma due to steroids. VKC may cause significant complications and lead to loss of vision.
