Abstract
Background: Vernal Keratoconjunctivitis (VKC) is a seasonally recurring bilateral allergic condition of the cornea and conjunctiva characterized by symptoms like itching, watering, foreign body sensation and ropy discharge. Chronic epithelial trauma provoked by eye rubbing due to intense ocular itching has been postulated as an important risk factor in the pathogenesis of keratoconus in VKC patients.
Objectives: To detect anterior corneal surface changes like astigmatism and keratoconus by topographic evaluation of cornea.
Methodology: This was a cross sectional study carried out on 424 eyes of 212 patients between 5 to 20 years of age at Post Graduate Department of Ophthalmology, Government Medical College, Srinagar between September 2016 and September 2018. Best Corrected Visual Acuity (BCVA), slit lamp examination, pachymetry, fundus examination and corneal topography was done in all the patients. Parameters like steep K, Sim K astigmatism, I-S difference and SRAX were analysed and keratoconus like topography noted.
Results: Out of 212 patients, 145 were males and 67 were females. Majority were in the age group of 5- 10 years. Among the study eyes, Kmax> 47.2 D was seen in 10.1 %, Sim K astigmatism > 1.5D in 29%, I-S difference > 1.2 D in 19.6 % , SRAX > 21° in 20% and K max>47.2 D + Sim K astigmatism > 1.5 D i.e keratoconus like topography was seen in 7.5 %.
Conclusion: Incidence of astigmatism and keratoconus in VKC patients is more when compared to general population of the same age group.
Keywords: Vernal Keratoconjunctivitis(VKC), Topography, Astigmatism, Keratoconus.
References
- Khan MD, Kundi N, Saeed N, Gulab A, Nazeer A F. A study of 530 cases of vernal conjunctivitis from the North West Frontier Province of Pakistan. Pak J Ophthalmol1986;2:111–14.
- Bonini S, Coassin M, Aronni S, Lambiase A. Vernal keratoconjunctivitis. Eye (Lond) 2004;18(4):345-51.
- Leonardi A, Busca F, Motterle L, Cavarzeran F, Fregona IA, Plebani M, et al. Case series of 406 vernal keratoconjunctivitis patients: a demographic and epidemiological study. Acta Ophthalmol Scand 2006: 84: 406–10.
- Müller GG, José NK, De Castro RS. Topical tacrolimus 0.03% as sole therapy in vernal keratoconjunctivitis: a randomized double-masked study. Eye & Contact Lens 2014;40(2):79-83.
- Kumagai N, Fukuda K, Fujitsu Y, Yamamoto K, Nishida T..Role of structural cells of the cornea and conjunctiva in the pathogenesis of vernal keratoconjunctivitis. Prog Retin Eye Res 2006;25(2):165-87.
- Rabinowitz YS. Keratoconus. Surv Ophthalmol. 1998; 42: 297–319.
- Demirbas NH, Pflugfelder SC. Topographic pattern and apex location of keratoconus on elevation topography maps. Cornea 1998; 17: 476–84.
- Totan Y, Hepsen IF, Cekic O,Gündüz A, Aydin E. Incidence of keratoconus in subjects with vernal keratoconjunctivitis: a video keratographic study. Ophthalmology 2001; 108: 824–7.
- Kaya V, Karakaya M, Utine CA,Albayrak S, Oge OF, Yilmaz OF. Evaluation of the corneal topographic characteristics of keratoconus with orbscan II in patients with and without atopy.2007 Sep; 26(8): 945-8.
- Leonardi, AG. Secchi.Vernal keratoconjunctivitis. Intl. Ophthalmol. Clin. 2003; 41(1): 41-58.
- Cameron JA, Al-Rajhi AA, Badr JA. Corneal ectasia in vernal keratoconjunctivitis. Ophthalmology 1989; 96(11): 1615-1623.
- Lindsay RG, B ruce AS, Gutteridge IF. Keratoconus associated with continual eye rubbing due to punctual agenesis. Cornea 2000; 19(4): 567-569.
- Gupta A, Sravanthi S. Corneal topography in vernal kerato-conjunctivitis (VKC). J. Evolution Med. Dent. Sci. 2018; 7(19): 2351-2354.
- Gautam V,Chaudhary M, Sharma AK, Shrestha GS, Rai PG. Topographic corneal changes in children with vernal keratoconjunctivitis: A report from Kathmandu, Nepal. Cont Lens Anterior Eye. 2015 Dec; 38(6):461-5.
- Lapid-Gortzak R, Rosen S, Weitzman S, Lifshitz T. Video-keratography findings in children with vernal keratoconjunctivitis versus those of healthy children. Ophthalmology. 2002; 109(11): 2018-23.
Corresponding Author
Dr Birjees Hakak
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Cell: 7006159156
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.116
