Vernal keratoconjunctivitis: What is it and how is it treated?

31/10/2024

Vernal keratoconjunctivitis is a chronic inflammatory disease that primarily affects children and adolescents. It is a severe form of allergic conjunctivitis that tends to be recurrent and seasonal, most often in spring and summer. This condition impacts the conjunctiva and cornea, and while it usually resolves by adulthood, it can lead to serious complications if not treated properly.

Symptoms:

• Intense itching
• Watering
• Redness
• Light sensitivity (photophobia)
• Foreign body sensation.
• Thick mucus discharge may also be present

Causes:

Vernal keratoconjunctivitis is linked to an immune-mediated allergic response. Triggers include environmental allergens, such as pollen, dust mites, or mold. Genetic factors and a personal or family history of allergies, such as asthma or allergic rhinitis, also play a role.

Treatment:

The treatment of vernal keratoconjunctivitis focuses on controlling symptoms and preventing corneal damage. Options include:

1. Topical antihistamines to reduce itching and inflammation.
2. Mast cell stabilizers to prevent histamine release.
3. Topical corticosteroids to reduce inflammation in more severe cases, used cautiously to avoid side effects such as increased intraocular pressure.
4. Artificial tears to keep the ocular surface lubricated.
5. Topical immunomodulators (such as cyclosporine or tacrolimus) in more severe cases.

Complications:

If not treated properly, vernal keratoconjunctivitis can cause complications such as corneal neovascularization, corneal opacities, ptosis (drooping of the eyelid) and other more serious issues like corneal ulcers and scarring, which in severe cases can lead to vision loss.

Regular follow-ups with an ophthalmologist are important, especially during periods of increased inflammation.

Dr. Anna Monés, ophthalmologist at the Barraquer Ophthalmology Centre