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Palpebral form- Usually upper tarsal conjunctiva of both the eyes is involved. Typical lesion is characterized by the presence of hard, flat-topped papillae arranged in cobblestone or pavement stone fashion. In severe cases papillae undergo hypertrophy to produce cauliflower-like excrescences of
389:(2%) drops 4–5 times a day are quite effective in controlling VKC, especially atopic ones. Azelastine eyedrops are also effective. Topical antihistamines can be used. Acetyl cysteine (0.5%) used topically has mucolytic properties and is useful in the treatment of early plaque formation. Topical
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Treatment of vernal keratopathy- Punctuate epithelial keratitis require no extra treatment except that instillation of steroids should be increased. Large vernal plaque requires surgical excision. Ulcerative vernal keratitis require surgical treatment in the form of debridement, superficial
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Bulbar form- It is characterised by dusky red triangular congestion of bulbar conjunctiva in palpebral area, gelatinous thickened accumulation of tissue around limbus and presence of discrete whitish raised dots along the
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Symptoms – VKC is characterised by marked burning and itchy sensations which may be intolerable and accentuates when patient comes in a warm humid atmosphere. Associated symptoms include mild
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Climate – More prevalent in the tropics. VKC cases are mostly seen in hot months of summer, therefore, more suitable term for this condition is "summer catarrh" Ref.
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VKC is thought to be an allergic disorder in which IgE mediated mechanism play a role. Such patients often give family history of other atopic diseases such as
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General measures include use of dark goggles to prevent photophobia, cold compresses and ice pack for soothing effects, change of place from hot to cold areas.
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Season – More common in summer. Hence, the name Spring catarrh is a misnomer. Recently it is being labelled as Warm weather conjunctivitis.
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Corneal involvement in VKC may be primary or secondary due to extension of limbal lesions. Vernal keratopathy includes 5 types of lesions.
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keratectomy, excimer laser therapeutic keratectomy, as well as amniotic membrane transplantation to enhance re-epithelialisation.
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Treatment of large papillae- Cryo application, surgical excision or supratarsal application of long-acting steroids.
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S Gokhale, Nikhil (2015-06-27). "Vernal
Keratoconjunctivitis Grading System and Step Ladder Management Approach".
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Cameron, J. A. (June 1995). "Shield ulcers and plaques of the cornea in vernal keratoconjunctivitis".
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Grade 3 SEVERE - Symptoms, photophobia, mild to moderate SPK's OR with
Diffuse SPK or corneal ulcer
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Conjunctival vessels also show proliferation, increased permeability and vasodilation.
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Signs of VKC can be described in three clinical forms (Cameron
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Local therapy- Topical steroids are effective. Commonly used solutions are of
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ointment (0.1%) used topically twice daily is showing encouraging results.
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Systemic therapy- Oral antihistamines and oral steroids for severe cases.
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Grade 2 MODERATE - Symptoms with photophobia but no corneal involvement
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Fibrous layer show proliferation which later undergoes hyaline changes.
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Based on severity, authors have classified VKC into clinical grades:
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Some of the cornea and conjunctiva findings in vernal conjunctivitis
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Desensitization has also been tried without much rewarding results.
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Mixed form- Shows the features of both palpebral and bulbar types.
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Spring catarrh; Vernal catarrh; Warm weather conjunctivitis
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and sends downward projection into sub-epithelial tissue.
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Age and sex – 4–20 years; more common in boys than girls.
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181:) is a recurrent, bilateral, and self-limiting type of
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Adenoid layer shows marked cellular infiltration by
354:Grade 1 MILD - Symptoms but no corneal involvement
46:. Unsourced material may be challenged and removed.
185:(pink eye) having a periodic seasonal incidence.
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200:Ulcerative vernal keratitis (shield ulceration).
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106:Learn how and when to remove this message
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498:(4th ed.). Paramount. p. 31.
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385:. Mast cell stabilizers such as
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494:Shah, Syed Imtiaz Ali (2014).
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432:Allergic conjunctivitis
206:Subepithelial scarring.
203:Vernal corneal plaques.
496:Concise Ophthalmology
272:and increased serum
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387:sodium cromoglycate
608:External resources
214:Signs and symptoms
189:Vernal keratopathy
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244:(Tranta's spots).
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326:histiocytes
318:lymphocytes
314:eosinophils
307:hyperplasia
225:lacrimation
221:photophobia
129:Other names
638:Categories
554:. Anshan.
438:References
414:tacrolimus
305:undergoes
303:epithelium
66:newspapers
473:0161-6420
375:medrysone
364:Treatment
339:Diagnosis
296:Pathology
258:hay fever
152:Specialty
617:Orphanet
421:See also
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