Vernal keratoconjunctivitis (VKC) is a chronic, seasonally exacerbated allergic eye disease that predominantly affects children and young males in warm climates.
Features
Intense itching, redness, stringy discharge, and light sensitivity are typical; large “cobblestone” papillae on the upper tarsal conjunctiva or limbal gelatinous thickening are characteristic.
- Rubbing can lead to keratoconus and further surface damage.
- Corneal involvement may produce punctate erosions, shield ulcers, or plaques.
- Symptoms often worsen in spring and summer.
- Associated atopic conditions such as eczema and asthma are common.
Treatment
Management uses a stepwise approach with allergen avoidance, cold compresses, and topical antihistamine/mast‑cell stabiliser drops, escalating to steroids or immunomodulatory agents when needed.
- Topical ciclosporin or tacrolimus can reduce steroid dependence in chronic cases.
- Regular monitoring is vital to detect corneal complications and steroid side effects.
- Education about avoiding eye rubbing helps protect the cornea.
- Most children improve after adolescence, though some have persistent disease.
