ABSTRACT
Background: Patient with vernal keratoconjunctivitis faces significant morbidity, which affects quality of life or; moreover, it can lead to vision threatening, corneal complication in severe cases and chronic cases coupled with potential iatrogenic side effects. Aim of this study to assess the demography, clinical features and quality of life of patients with vernal keratoconjunctivitis in a centre in South India.Methods: General objective is to access the health related-quality of life and demographic study of VKC patients in a tertiary eye care hospital in south India. KINDL questionnaire with 30 questions is used for 30 paediatric patients. Percentage analysis for clinical assessment and interpretation method for questionnaire was used as statistical method.Results: In clinical assessment papillary reaction (96.66%), giant papillae (83.34%), Horner Trantas dots (20%), shield ulcer (13.35%), corneal erosions (43.33%), conjunctival congestion (76.68%). In case of vision 36.66% had normal vision, 56.67% had mild vision loss, 6.68% with moderate vision loss.Conclusions: VKC affects the health related quality of life of the patients significantly. The management of VKC should consider this aspect of health related quality of life, in addition to clinical parameters. From the assessment of KINDL questionnaire 30 samples 18 patients had high and 12 patients had average quality of life.
ABSTRACT
Vernal keratoconjunctivitis(VKC)is a chronic bilateral inflammation of the conjunctiva, commonly associated with a personal or family history of atopy. It is characterized by severe itching, foreign body sensation, thick ropy discharge, photophobia and conjunctival injection. VKC has palpebral, limbal and mixed forms. The classical conjunctival sign in palpebral VKC is the presence of giant papillae, which are predominantly seen on the superior tarsal conjunctiva. The limbal form occurs in dark skinned individuals and the papillae tend to occur at the limbus and have a thick gelatinous appearance. Clinical findings and laboratory investigations support the presence of IgE mediated type1 hypersensitivity reaction. Involvement of CD4 T helper (Th2) driven type IV hypersensitivity has also been confirmed. There has been an increase in the prevalence of allergic disorders in recent years and exaggerated manifestations of these diseases have been recognized in patients living with Human immunodeficiency virus
ABSTRACT
Purpose: The aim of this study is to describe a modified surgical technique of continuous intraoperative optical coherence tomography (iOCT)-guided shield ulcer debridement with tuck-in multilayered Amniotic membrane transplantation (ML AMT) in vernal keratoconjunctivitis (VKC) with shield ulcer with plaque. Methods: Seven eyes of seven patients presenting with VKC with shield ulcer with plaque were enrolled in this prospective case series and planned for shield ulcer debridement with ML AMT. Debridement of the ulcer base with double-layered AMT was done under the continuous guidance of iOCT. The main outcome measure was the time for complete reepithelialization. Statistical analysis was performed using the Stata-14.0 program for Windows. Data were presented as mean � standard deviation/median (minimum-maximum) and frequency percentage as applicable. Results: The surgery could be completed successfully in all cases and iOCT could provide real-time assessment of the depth of dissection during the entire procedure. The duration of complete healing and disintegration of amniotic membrane varied from 7 to 12 days. Recurrence was not seen in any case till 2 months follow-up. Conclusion: iOCT provides continuous monitoring of the depth of dissection and allows for a safe and complete debridement of the shield ulcer with plaque.
ABSTRACT
Vernal Keratoconjuctivitis(VKC) is a recurrent, allergic seasonal disease of childhood characterized by severe inflammation of the conjunctiva and giant papillae of the superior tarsal conjunctiva, gelatinous hypertrophy of limbus and keratopathy. Clinical and inmuno histochemical studies suggest that IgE dependent and IgE independent mechanisms are involved in the inmuno pathogenesis of VKC. Allergic disease affects 30-50% of the population. Most of the patients are present in the month of May to June. In this study, it has been found that 156(74.29%) patients show seasonal symptoms and 43(20.48%) patients show perennial symptoms out of total 210 patients. KVC has predilection for young age group and the diagnosis is generally based on signs and symptoms of the disease. This study is undertaken to stress upon the disease and those secondary to its long term medication.
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Purpose: To study the demographic and clinical profile of patients with vernal keratoconjunctivitis (VKC) at a tertiary eye care center in India. Materials and Methods: Retrospective chart analysis of 468 patients of VKC seen from January 2006 to December 2006. Results: Mean age at presentation was 12 years. Majority of the patients had mixed pattern disease (72%). Chronic perennial disease was seen in 36% patients. Personal or family history of allergies was noted in 5% patients. Severe disease based on clinical grading was present in 37% patients. Moderate to severe vision loss was seen in 12% of total population. Persistent disease beyond 20 years of age was found in 12% patients. VKC‑related complications such as corneal scarring (11%), shield ulcer (3%), keratoconus (6%), and limbal stem cell deficiency (1.2%) were seen. Treatment‑related complications like corticosteroid‑induced cataract and glaucoma were seen in 6% and 4% of patients, respectively. Conclusion: Clinical pattern of VKC seen in the tropical climate of India is essentially similar to that seen in other tropical countries. Few distinct features that we noted represent chronic perennial disease, low association with atopy, and higher propensity for disease and treatment‑related complications.
ABSTRACT
PURPOSE: Human amniotic membrane has been used to variable ocular surface disorder. We report a case of the usefulness of amniotic membrane transplantation (AMT) for vernal keratoconjunctivitis "Shield ulcer". METHODS: A 12-year-old male patient was diagnosed to have vernal keratoconjunctivitis "Shield ulcer" and treated with medical therapy for four weeks. But he showed severe itiching, foreign body sensation, decreased visual acuity and continued to corneoconjunctival lesion and then, Amniotic membrane transplantation with stromal side down was performed after debridement of the ulcer bed and therapeutic contact lens was applied. RESULTS: At tenth day after AMT, ulcer size was decreased and corneal state was generally improved with restoration of visual acuity. One month after, he has been comfortable with improved visual acuity, giant papillae of upper tarsal conjunctiva was nearly complete remission. CONCLUSIONS: AMT is an effective method for managing vernal keratoconjunctivitis "Shield ulcer", that are refractory to conventional medical treatment.