Severe clinical features in Vernal Keratoconjunctivitis

• Published in: Acta ophthalmologica (Oxford, England) England), 2016-10, Vol.94 (S256), p.n/a
• Main Author: Lazreg, S.
• Format: Article
• Language: English
• Subjects: Allergens; Allergies; Astigmatism; Children; Climate; Complications; Conjunctiva; Cornea; Desensitization; Eye; Incidence; Keratitis; Keratoconjunctivitis; Keratoconus; Lesions; Males; Medical treatment; Ophthalmology; Papillae; Plaques; Rubbing; Steroid hormones; Steroids; Ulcers
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2016.0136

Summary Vernal keratoconjunctivitis (VKC) is a severe form of ocular allergy, that can causes severe visual complications, it is more frequent on warm climates. VKC occurs mainly in children, the incidence is higher in males by a ratio of 3 to1, and usually appears seasonally, from early spring untill automn. Clinically we can observe 3 forms, tarsal VKC, limbal and mixed forms, tarsal forms are the most common, with a giant papillae in the tarsal side of the conjunctiva, limbal forms may be oeudematous or nodular with trantas nods. Cornea is very frequently involved, and corneal lesions are various from punctuate keratitis to ulcers and in some cases to vernal plaques. Most of the patients presents an irregular astigmatism, and some of them keratoconus probably due to eye rubbing. The first step of the treatment is to identify the allergens by the allergologist, to avoid them or to begin desensitization. Medical treatment consists on topical steroids during acute phases, associate to topical mast cell stabilizers; for severe cases topical ciclosporine 2% is prefered to steroids, when it is available, if not, intratarsal injection of triamcinolone can help to improve corneal healing, vernal plaques must be removed surgically.