Corneal complications of vernal keratoconjunctivitis

Solomon, Abraham

doi:10.1097/aci.0000000000000202

Cited by 48 publications

(36 citation statements)

References 23 publications

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“…[ 10 11 ] VKC is a chronic allergic disease affecting tarsal conjunctiva and limbus. [ 12 13 ] It is an IgE-mediated hypersensitivity reaction where binding of allergen-specific IgE to high-affinity IgE receptors on mast cells releases histamines and other cytokines causing inflammation. [ 12 ] Histamine is a mediator of itch response,[ 5 ] which triggers eye rubbing leading to KC progression by increasing protease activity.…”

Section: Discussionmentioning

confidence: 99%

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Shetty

Sureka

Kusumgar

et al. 2017

Indian J Ophthalmol

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We report two male children with persistent allergic eye disease (AED) and keratoconus (KC). Both presented with symptoms of vernal keratoconjunctivitis and decreased vision. In view of unrelenting AED, serum immunoglobulin E (IgE) quantification and identification of specific allergens were advised. Increased serum IgE levels were observed in both cases. Sunflower and sheep wool were identified as specific allergens for the first and second patient respectively by skin patch test. There was complete resolution of symptoms of AED in both patients following avoidance of causative allergens. However, the progression of KC in both eyes of the first patient and one eye of the second patient was observed. They were advised collagen cross-linking. Elevated serum IgE indicates the presence of systemic allergy. Avoiding implicated allergens help alleviate ocular symptoms. Using serum IgE and identifying specific allergen can guide in the treatment of AED and thus prevent progressive KC due to eye rubbing and resulting inflammation.

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Section: Discussionmentioning

confidence: 99%

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Shetty

Sureka

Kusumgar

et al. 2017

Indian J Ophthalmol

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“…Routine corneal topography in patients with VKC allows early detection and management of subclinical and clinical keratoconus. [7][8][9] Gautam and his friends conducted a study on VKC patients in Nepal. 28.7% of patients was diagnosed with palpebral, 14.8% of patients was diagnosed with limbal and 56.5% of patients was diagnosed with mixed VKC.…”

Section: Discussionmentioning

confidence: 99%

“…It has been showed that chronic epithelial defects result in changes in corneal topography by causing long term and slight oscillation in destructive enzymes. 3,[7][8][9] The studies conducted in previous years have shown the relation between keratoconus and VKC with clinical analysis. [9][10][11] Yet, with these methods, it cannot be proven the relationship between VKC and keratoconus in the patients with subclinical keratoconus.…”

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confidence: 99%

The Topographic Corneal Changes in Patients with Vernal Keratoconjunctivitis

Ekinci¹,

Alparslan²,

Cebeci³

et al. 2019

Turkiye Klinikleri J Ophthalmol

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The aim of this study is to compare the topographic corneal changes in patients with Vernal keratoconjunctivitis, to a control group. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 41 patients (81 eyes) with active vernal keratoconjunctivitis and 41 control subjects (82 eyes) were included in this prospective study. The Corneal topography of subjects were examined with Pentacam (Oculus HR inc., Germany). R Re es su ul lt ts s: : The eyes with vernal keratoconjunctivitis was palpebral in 32 eyes (39.5%), limbal in 24 eyes (29.6%), and mixed in 25 eyes (30.9%). There were no statistically significant differences between groups in K1, K2, Kaverage. On the other hand, the mean Kmaximum value was much higher in the patient group than the control group. There were statistically significant differences between the groups for the mean astigmatism, thickness at the thinnest location, thickness at the apex of the cornea, the difference in the thickness between the apex and the thinnest location, the mean anterior and posterior elevation peak and keratoconus index. According to our parameters, 7 of the 41 subjects (17.07%) were detected as keratoconus and 9 of the 41 subjects (21.95%) were detected as subclinic keratoconus in vernal keratoconjunctivitis group. The correlation between age and keratoconus parameters was not statistically significant in the group with keratoconus. In patients with subclinical keratoconus, the elevation of Kmaximum values was statistically significant as their ages progressed. There was no correlation between a set of factors that are the age, the gender, duration of the symptoms and types of vernal keratoconjunctivitis in patient group and development of keratoconus and subclinic keratoconus. C Co on nc cl lu us si io on n: : In our study, in comparison to the control group, more topographic changes in favor of keratoconus and subclinical keratoconus were detected in patients with vernal keratoconjunctivitis. In patients with vernal keratoconjunctivitis, analysis of corneal topography is important for early diagnosis of keratoconus. K Ke ey yw wo or rd ds s: : Vernal keratoconjunctivitis; topography; keratoconus Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, kliniğimizdeki vernal keratokonjonktivit tanılı hastaların korneal topografik değişimlerinin kontrol grubu ile karşılaştırılması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif çalışmaya; vernal keratokonjonktivit tanılı 41 hastanın 81 gözü ile 41 kontrol hastasının 82 gözü alındı. Korneal topografi, Pentacam (Oculus HR inc., Almanya) ile değerlendirildi. B Bu ul lg gu ul la ar r: : Vernal keratokonjonktivit tanısı konan gözlerin 32'si (%3,5) palpebral, 24'ü (%29,6) limbal, 25'i (%30,9) karışık tipteydi. Gruplar arasında K1, K2, Kortalama değerleri açısından anlamlı fark saptanmadı. Diğer taraftan, Ken yüksek ortalaması ise hasta grubunda kontrol grubuna göre anlamlı olarak yüksekti. Astigmat değeri ortalaması, kornea en ince noktası ile kornea apeksinin pakimetri değeri, kornea apeksi ile en inc...

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“…[29] Corneal complications appear to be one of the earliest causes of visual impairment and can cause permanent decrease or loss of vision in children. [30] Vision screening alone, although recommended in primary school children, will not identify VKC cases. Therefore, incorporating eye examinations into the routine vision screening is recommended.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of vernal keratoconjunctivitis: A population study of primary school children in Nigeria

Duke

Egbula

Smedt³

2017

JER

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Objective: The objective of the study is to describe pertinent clinical features of vernal keratoconjunctivitis (VKC) seen in public primary school children in Nigeria, Africa.Methods: A cross sectional survey of children with VKC was conducted in a population of school children using a multistage sampling method. Comprehensive eye examinations were conducted including visual acuity, refraction, anterior and posterior segment examinations, ocular adnexal examinations and symptomatic break up time (SBUT) for tear assessment.Results: Out of 1,226 primary school children examined, 223 children had VKC. The most common complaints were itching 150 (67.3%), brownish discoloration of the eyes 132 (59.2%) and stringy mucoid discharge 109 (48.9%). The total prevalence of atopy in this population was 30%. Normal vision was seen in 223 (100%) children, while 5 (0.9%) children presented with monocular moderate visual impairment. Ptosis from VKC was seen as a significant (p < .0001) finding in the tarsal clinical type 55 (24.7%) and 60 (26.9%) right and left eyes respectively. Left eye lid chalazion was also significantly associated with tarsal type of VKC (p < .0001). Common corneal complications noted were sub epithelial scarring 22 (9.9%) and pseudogerontoxon 7 (3.1%). Symptomatic tear film break-up time of < 5 seconds was seen more frequently among children 156 (70%) with VKC even though this was not statistically significant (p = .737).Conclusion: The clinical features of VKC is similar to most population studies, including corneal complications. Eye lid pathologies including chalazion, external hordealon and ptosis were common features seen in this population. Better primary eye care for the management of VKC in children may prevent corneal complication.

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Corneal complications of vernal keratoconjunctivitis

Abstract: Corneal complications in VKC are the result of an on-going process of uncontrolled inflammation. Proper recognition of the corneal complications in VKC is crucial, as most of these can be managed or prevented by a combination of medical and surgical measures.

Cited by 48 publications

References 23 publications

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

The Topographic Corneal Changes in Patients with Vernal Keratoconjunctivitis

Clinical features of vernal keratoconjunctivitis: A population study of primary school children in Nigeria

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