Vernal Keratoconjunctivitis: Beyond the Classic Treatment

Abstract

Vernal keratoconjunctivitis is a chronic allergic conjunctivitis with corneal involvement that affects children and adolescents. Its pathogenic mechanisms are not entirely clear, but IgE and other inflammatory mediators are involved. An 8-year-old boy with vernal keratoconjunctivitis not responding to conventional treatment started immunotherapy with good results, decreasing the topical steroid dependence. Conventional vernal keratoconjunctivitis treatment involves topical antihistamines and steroids. These are not always effective and steroids can be associated with severe ocular complications in the long term. The authors suggest searching for possible allergens and starting immunotherapy associated with conventional topical treatment earlier, in addition to measuring the health-related quality of life by applying the Quality of Life in Children with Vernal Keratoconjunctivitis questionnaire and adjusting the treatment according to the impact on patients' quality of life. [ J Pediatr Ophthalmol Strabismus. 2021;58(5):e36–e39.]

Vernal keratoconjunctivitis: Current immunological and clinical evidence and the potential role of omalizumab

“… 9 , 10 The condition often resolves spontaneously after puberty but, in approximately 12% of patients, it persists beyond 20 years of age. 7 , 11 Approximately 50% of patients with VKC have an atopic background as assessed by a skin prick test or serum-specific immunoglobulin E (IgE) measurements. 12 , 13 …”

“…In some patients, prolonged use of topical steroids may lead to iatrogenic complications, including cataracts, ocular hypertension, glaucoma, and corneal infection ( Table 1 ). 10 , 11 , 12…”