Dry Eye in Vernal Keratoconjunctivitis: A Cross-Sectional Comparative Study

Area of Science:

• Ophthalmology
• Pediatric Eye Care
• Dry Eye Disease

Background:

• Vernal keratoconjunctivitis (VKC) is a bilateral, itching, seasonal eye inflammation primarily affecting children and adolescents.
• VKC is associated with various ocular surface complications, including dry eye, which can persist even during inactive disease phases.

Purpose of the Study:

• To evaluate standardized clinical tests for diagnosing dry eye in pediatric patients with active and inactive VKC.
• To compare the ocular surface status of VKC patients with age-matched healthy controls.

Main Methods:

• A comparative cross-sectional study involving 35 active VKC, 35 inactive VKC, and 70 healthy children.
• Comprehensive eye examinations included visual analog scale for symptoms, biomicroscopy, tear film break-up time (BUT), corneal and conjunctival staining, corneal esthesiometry, Schirmer test, and meibomian gland assessment.

Main Results:

• Active VKC patients exhibited significantly more severe symptoms and ocular surface disease signs compared to inactive VKC and control groups.
• Inactive VKC patients showed increased photophobia, conjunctival staining, and higher Schirmer test values.
• Inactive VKC patients also demonstrated reduced tear film BUT and corneal sensitivity compared to controls.

Conclusions:

• The study confirms a strong association between VKC and dry eye disease, characterized by a short tear film BUT.
• Ocular surface abnormalities, including impaired tear film stability, epithelial integrity, and corneal nerve function, are present in VKC patients even during quiescent phases.
• The long-term effects of this chronic ocular surface damage mechanism in VKC require further investigation.