Vernal keratoconjunctivitis (VKC) is a recurrent, bilateral, and self-limiting inflammation of conjunctiva, having a periodic seasonal incidence. Vernal keratopathy
Corneal involvement in VKC may be primary or secondary due to extension of limbal lesions. Vernal keratopathy includes 5 types of lesions. Punctuate epithelial keratitis. Ulcerative vernal keratitis (shield ulceration). Vernal corneal plaques. Subepithelial scarring. Pseudogerontoxon. Sign and symptoms
Symptoms- VKC is characterised by marked burning and itchy sensations which may be intolerable and accentuates when patient comes in a warm humid atmosphere. Associated symptoms include mild photophobia in case of corneal involvement, lacrimation, stringy discharge and heaviness of eyelids. Signs of VKC can be described in three clinical forms (Cameron Classification):Palpebral form- Usually upper tarsal conjunctiva of both the eyes is involved. Typical lesion is characterized by the presence of hard, flat-topped papillae arranged in cobblestone or pavement stone fashion. In severe cases papillae undergo hypertrophy to produce cauliflower-like excrescences of giant papillae. Bulbar form- It is characterised by dusky red triangular congestion of bulbar conjunctiva in palpebral area, gelatinous thickened accumulation of tissue around limbus and presence of discrete whitish raised dots along the limbus (Trantas spots). Mixed form- Shows the features of both palpebral and bulbar types. Cause
VKC is thought to be an allergic disorder in which IgE mediated mechanism play a role. Such patients often give family history of other atopic diseases such as hay fever, asthma or eczema, and their peripheral blood shows eosinophilia and increased serum IgE levels. Risk factors
Age and sex – 4–20 years; more common in boys than girls.
General measures include use of dark goggles to prevent photophobia, cold compresses and ice pack for soothing effects, change of place from hot to cold areas. Desensitization has also been tried without much rewarding results. Treatment of vernal keratopathy- Punctuate epithelial keratitis require no extra treatment except that instillation of steroids should be increased. Large vernal plaque requires surgical excision. Ulcerative vernal keratitis require surgical treatment in the form of debridement, superficial keratectomy, excimer laser therapeutic keratectomy, as well as amniotic membrane transplantation to enhance re-epithelialisation. Recently treatment with tacrolimus ointment (0.1%) used topically twice daily is showing encouraging results. See also
Conjunctivitis
Allergic conjunctivitis

References
Further reading
Khurana, A. K. (2014). Comprehensive ophthalmology. Anshan. ISBN 978-1-84829-072-3. == External links ==