Vernal keratoconjunctivitis

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Vernal keratoconjunctivitis
Other namesSpring catarrh; Vernal catarrh; Warm weather conjunctivitis
Vernal.jpg
Some of the cornea and conjunctiva findings in vernal conjunctivitis
Specialty Ophthalmology

Vernal keratoconjunctivitis (VKC, also Spring catarrh, Vernal catarrh or Warm weather conjunctivitis) is a recurrent, bilateral, and self-limiting type of conjunctivitis (pink eye) having a periodic seasonal incidence.

Contents

Vernal keratopathy

Corneal involvement in VKC may be primary or secondary due to extension of limbal lesions. Vernal keratopathy includes 5 types of lesions.[ citation needed ]

  1. Punctuate epithelial keratitis.
  2. Ulcerative vernal keratitis (shield ulceration).
  3. Vernal corneal plaques.
  4. Subepithelial scarring.
  5. Pseudogerontoxon.

Signs and symptoms

  1. 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 'giant papillae'.
  2. 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 limbus (Tranta's spots).
  3. Mixed form- Shows the features of both palpebral and bulbar types.

Cause

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 hay fever, asthma or eczema, and their peripheral blood shows eosinophilia and increased serum IgE levels.

Risk factors

Pathology

Diagnosis

Classification

Based on severity, authors have classified VKC into clinical grades: [3]

Grade 0 - Absence of symptoms

Grade 1 MILD - Symptoms but no corneal involvement

Grade 2 MODERATE - Symptoms with photophobia but no corneal involvement

Grade 3 SEVERE - Symptoms, photophobia, mild to moderate SPK's OR with Diffuse SPK or corneal ulcer

Treatment

See also

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References

  1. Cameron, J. A. (June 1995). "Shield ulcers and plaques of the cornea in vernal keratoconjunctivitis". Ophthalmology. 102 (6): 985–993. doi:10.1016/s0161-6420(95)30925-6. ISSN   0161-6420. PMID   7777308.
  2. Shah, Syed Imtiaz Ali (2014). Concise Ophthalmology (4th ed.). Paramount. p. 31. ISBN   978-969-637-001-7.
  3. S Gokhale, Nikhil (2015-06-27). "Vernal Keratoconjunctivitis Grading System and Step Ladder Management Approach". Delhi Journal of Ophthalmology. 25 (2): 85–89. doi:10.7869/djo.84.

Further reading