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Management of vernal keratoconjunctivitis in children in Saudi Arabia
1Department of Ophthalmology, Medical College, Qassim University, Qassim, Saudi Arabia.
Insights
Vernal keratoconjunctivitis, a severe allergic eye disease, requires age-specific topical management in children. Early cycloplegic refraction and lubricating eye drops are crucial for preventing complications like keratoconus.
Area of Science:
- Ophthalmology
- Allergology
- Pediatrics
Background:
- Vernal keratoconjunctivitis (VKC) is a chronic, severe allergic eye disease.
- It can lead to sight-threatening corneal complications if untreated.
- VKC primarily affects children around age 7.
Purpose of the Study:
- To review and highlight age-specific topical management strategies for VKC in pediatric patients.
- To emphasize the importance of cycloplegic refraction and lubricating eye drops in managing VKC.
- To identify challenges in accessing advanced VKC treatments in specific regions.
Main Methods:
- Systematic literature search using keywords in PubMed, Google Scholar, EMBASE, and Cochrane.
- Focus on pediatric VKC management and topical treatment differences across age groups.
- Analysis of available and inaccessible treatments in Saudi Arabia.
Main Results:
- Limited literature specifically addresses pediatric VKC treatment.
- Topical management strategies differ significantly between age groups.
- Cycloplegic refraction is vital due to high risks of keratoconus and oblique astigmatism.
- Eye lubricants serve as both therapeutic and preventive tools.
- Several advanced treatments (e.g., tacrolimus, high-concentration Cyclosporine A) are unavailable or restricted in Saudi Arabia.
Conclusions:
- Age-tailored topical management is essential for pediatric VKC.
- Ocular lubricants and cycloplegic refraction are key components of care.
- Treatment accessibility issues for advanced medications in Saudi Arabia require attention.
Abstract:
Vernal keratoconjunctivitis is a chronic inflammatory disease of the ocular surface and one of the worst types of allergic conjunctival diseases. Because of its chronic nature, it can damage the cornea, resulting in sight-threatening complications if left untreated. The disease affects mainly young children starting around the age of 7 years. We used keywords to search for published English articles in PUBMED, Google Scholar, EMBASE, and Cochrane Database of Systematic Reviews. Most of the published literature is focusing on general management of the disease and few publications focusing on treatment in the pediatric age group. We highlight the importance of how is the topical management differs between age groups. We focused on the importance of doing cycloplegic refraction for each child as the risk of keratoconus and oblique astigmatism is high in these cases. Furthermore, we highlight the importance of using eye lubricants as a therapeutic and preventive tool for the attacks of the disease. We highlight that most of the recent effective medications (especially the off-label ones) are not available in Saudi Arabia, such as tacrolimus, and some are only available to be prepared in tertiary center pharmacies as Cyclosporine A with higher concentrations.
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