Vernal keratoconjunctivitis treatment

How to treat vernal keratoconjunctivitis?

Vernal keratoconjunctivitis (VKC) is another form of allergic conjunctivitis, the rarest and more severe one, which mostly affects children from the age of two. Not very well known by the public, it is the most dangerous form of conjunctivitis for one’s sight. WE invite you to discover this ocular disease through its definition, symptoms, risks and treatment.

vernal keratoconjunctivis

What is

vernal keratoconjunctivitis?

Vernal keratoconjunctivitis is an allergic, chronic and inflammatory disease derived from allergic conjunctivitis. This more severe form will result in an inflammation of the conjunctiva (the mucous membrane that lines the eyelid and eye surface) as well as a keratitis (corneal inflammation).

There are several forms of VKC:

  • tarsal VKC: characterized by a swelling of the eyelid, caused by the presence of an allergic papilla in this area;

  • superior limbic VKC: we notice an accrual of epithelial cells at the corneal conjunctiva junction, as well as the Horner-Trantas dots;

mixed type VKC: combines both of the aforementioned ones

The vernal keratoconjunctivitis is seasonal. It manifests mostly during spring and summer. In rarer cases, it can be pre-annual and chronic.

Do not hesitate to consult with our ophthalmologist if you feel itches on your eyelids, or if you’re subject to seasonal allergies!

Vernal keratoconjunctivitis is a rare ocular pathology: less than one person in 2000 is affected by it, and most of them are:

  • children between 2 and 14 years old;
  • boys (⅔ of the young patients)
  • highly exposed to UV, which can trigger allergic reactions;

inhabitants of the south areas of the North hemisphere.

In France, we observe that 15 to 20% of the population is affected by allergic conjunctivitis. The youngest needs to be monitored for it represents a severe corneal damage.

In most patients, VKC gets better and can even totally vanish during puberty. But 5% of the adults who suffered from that pathology during childhood continue to be affected with this ocular disease. VKC in adults affects men and women equally. Finally, this pathology grows more easily on atopic individuals.

Who is affected by

vernal keratoconjunctivitis?

What are the symptoms of vernal keratoconjunctivitis?

Symptomatology of vernal keratoconjunctivitis is perennial. However, symptoms get worse during spring and summer. They are close to the allergic conjunctivitis ones, but also worse and more intense:

  • major pruritus, caused by a feeling of itching and burning, sore tinglings;
  • photophobia;
  • very red eyes and swallowed under palpebral papillae, which can rub and damage the pupil.

 

Contrary to a simple conjunctivitis, VKC can lead to an impairment of the child’s vision, and requires a quick visit to your eye specialist. If you observe these symptoms, quickly make an appointment or go to the ophthalmological emergencies.

What are the risks of

vernal keratoconjunctivitis ?

During the consultation, the ophthalmologist will perform a set of tests in order to evaluate the ocular damages caused by the vernal keratoconjunctivitis. We also advise you to meet an allergologist in order to establish the causes to your ocular allergies (blood and/or skin tests).

These ophthalmological exams are required to establish the type, or types of VKCs, as described in the “what is vernal keratoconjunctivitis?” paragraph we are dealing with.

Vernal keratoconjunctivitis can cause more or less severe corneal lesions.

  • ulcers, like torpid ulcer;
  • vernal plaques (containing fibrin and mucous);
  • keratoconus;
  • a decrease of acuity, like a strong astigmatism, or a blindness even.

What are the treatments of

vernal keratoconjunctivitis ?

Treatments of vernal keratoconjunctivitis are essentially local, such as eye-drops, corticotherapy and contact lenses.

The eye-drops are antihistamine with local or systemic administration. In addition, your ophthalmologist can opt for a cyclosporine emulsion, administered with vigilance. 

If your caregiver chooses to integrate a corticoid treatment, rest assured, the dose is evaluated and adapted to your child.

Another possibility is to put a silicone hydrogel contact lens on one or both eyes affected with VKC. Its purpose is to protect the cornea, allowing it to heal in the process.

If your child suffers from VKC induced astigmatism afterward, a glass prescription will be issued, and possibly orthoptic sessions as well.

vernal keratoconjunctivis treatment

As a conclusion

Vernal keratoconjunctivitis is a severe allergic reaction that mostly affects children and young boys. Diagnosed in time, and with the proper treatment, the child’s cornea can be preserved. Even though this pathology can be seasonal and vanish when puberty hits, it is necessary to take young patients in charge as quickly as possible in order to avoid further complications!

To be discovered

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