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

Edoardo Villani1, Marika Dello Strologo, Francesco Pichi

  • 1From the Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Milan (EV, MDS, FP, SVL, MS, PN); Eye Clinic Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara (SDC); and Eye Clinic San Paolo Hospital, Milan, Italy (SDC).

Medicine
|October 27, 2015
PubMed

Insights

Vernal keratoconjunctivitis (VKC) is linked to dry eye disease, even in its inactive phase. This study highlights persistent ocular surface abnormalities in children with VKC, impacting tear film and corneal nerves.

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.

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