Vernal keratoconjunctivitis: a severe allergic eye disease with remodeling changes

Area of Science:

• Ophthalmology
• Allergology
• Pediatrics

Background:

• Vernal keratoconjunctivitis (VKC) is a severe, sight-threatening allergic eye condition primarily affecting children.
• Standard allergic conjunctivitis treatments are often insufficient for VKC, and pediatricians/allergists may lack familiarity with its severe symptoms.
• Untreated VKC can lead to permanent visual impairment, necessitating awareness of effective management strategies.

Purpose of the Study:

• To review current understanding of VKC pathogenesis.
• To highlight the importance of specialized management for VKC in children.
• To discuss therapeutic options and potential complications of VKC.

Main Methods:

• Review of current literature on VKC pathogenesis and treatment.
• Analysis of clinical presentation, diagnostic signs, and common therapeutic approaches.
• Discussion of complications and emerging research.

Main Results:

• VKC presents with severe ocular symptoms like itching, tearing, redness, discharge, and photophobia.
• Key examination findings include giant papillae, Horner-Trantas dots, and thick mucus discharge, with eosinophils predominant in ocular secretions.
• Conventional therapies (antihistamines, dual-acting agents) are often inadequate, frequently requiring topical corticosteroids, which carry risks of side effects like glaucoma and cataracts.

Conclusions:

• VKC is a significant pediatric allergic eye disease with unique complications that can cause blindness.
• Understanding VKC pathogenesis is essential for developing improved therapies.
• Prompt and appropriate management by pediatric allergists is vital to achieve remission and minimize long-term sequelae.