Diagnosis:


  • A bilateral , recurrent conjunctivitis, occurs predominantly in males aged 5 - 20 with peak incidence between 11 and 13 years
  • Usually a personal or family history of atopy
  • Symptoms are commonly exacerbated in the spring/ summer, but in tropical climates the disease may persist year-long

Clinical findings:
Symptoms: itching, photophobia, blurred vision, thick "ropy" discharge and blepharospasm
Signs:
Palpebral VKC
Bulbar conjunctival hyperemia and chemosis
Characteristic polygonal, flat-topped, pale pink/ grayish "cobblestones" papillae are located predominantly on the upper tarsal conjunctiva
Limbal VKC may develop alone or in association with palpebral VKC
Appears as thickening and opacification of the limbus
Limbal nodules may develop and become confluent
Horner-Trantas' dots may be seen as small white elevated lesions that represent macroaggregates of desquamated epithelial cells and eosinophils
Corneal changes that may occur include:
Punctate epithelial erosion
Superficial pannus
Shield ulcer; noninfectious, oval-shaped, circumscribed epithelial ulcer with underlying stromal opacification in the superior or central cornea. After the ulcer heals, an anterior stromal opacity persists.

Treatment:

Topical antihistamine may have some role in the treatment of mild cases
Topical mast-cell stabilizer such as cromolyn sodium or lodoxamide is indicated for moderate to severe cases and should be started at least one month prior to seasonal onset of symptoms
Topical corticosteroids may be required in a severely inflamed eye or when there is a shield ulcer
Moving to a cooler climate reduces the likelihood of disease recurrence

Images:

spring catarrh vernal keratoconjunctivitis (diagnosis attachment.php?s=e8f28584f713571d9e2fb20dd3ef5ab6&attachmentid=2832&d=1458968694
spring catarrh vernal keratoconjunctivitis (diagnosis attachment.php?s=e8f28584f713571d9e2fb20dd3ef5ab6&attachmentid=2833&d=1458968695
spring catarrh vernal keratoconjunctivitis (diagnosis attachment.php?s=e8f28584f713571d9e2fb20dd3ef5ab6&attachmentid=2834&d=1458968696
spring catarrh vernal keratoconjunctivitis (diagnosis attachment.php?s=e8f28584f713571d9e2fb20dd3ef5ab6&attachmentid=2835&d=1458968698





Videos:





Supratarsal Injection of Triamcinolone in Recalcitrant VKC Dr Suresh K Pandey