Demographic and clinical profile of vernal keratoconjunctivitis and testing of health related quality of life in a tertiary hospital in South India

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.

Clinical Profile Of Vernal Keratoconjunctivitis A Hospital Based Study(Subhimalayan Region Of North Bengal, W.B, India)

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.

Conjunctival Inclusion Cysts in Long-standing Chronic Vernal Keratoconjunctivitis

PURPOSE: To report a case of conjunctival inclusion cysts on the corneal limbus of a patient with chronic vernal keratoconjunctivitis during 16 months' follow up. METHODS: The patient was a 26 year old male without any specific history of surgery or trauma. Giant papillae, shield ulcers, and Horner-Trantas dots were detected. During the 16 month follow-up, Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops were given 3 times a day. During this period, conjunctival cysts were detected on the corneal limbus in both eyes. In spite of improvement of the corneal and conjunctival conditions, the conjunctival cysts did not seem to show any specific changes. For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed. RESULTS: On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance. Inflammatory cells were not found in the vicinity. CONCLUSIONS: Conjunctival inclusion cysts can be seen as an atypical finding of long-standing vernal keratoconjunctivitis. Mechanical friction between the giant papillae and conjunctiva may be a factor in inducing the formation of the conjunctival cysts.

Resection and Cryotherapy Combined with Amniotic Membrane Transplantation for the Treatment of Vernal Keratoconjunctivitis with Giant Papillae / 华中科技大学学报（医学）（英德文版）

To evaluate the efficacy and safety of resection and cryotherapy combined with amniotic membrane transplantation (AMT) for the treatment of vernal keratoconjunctivitis (VKC) with giant papillae (GP). Eight patients (16 eyes involved) with VKC, characterized by GP on the upper tarsal conjunctiva, underwent resection and cryotherapy in combination with AMT. The follow-up lasted for 3-22 months. The results showed that corneal shield ulcers and superficial punctuate keratitis healed during the first week after surgery and did not recur. Fourteen eyes (87.5 %) were symptom-free 1 month after surgery, and no GP, ectropion, trichiasis and other complications were noted, but the blood vessels of upper tarsal conjunctiva could not be clearly seen and a little conjunctival scar was observed. Recurrence of GP was observed in 2 eyes (12.5 %), with the area being less and irritation milder as compared with those before the operation. Among the two eyes, one eye was treated by cyclosporine eyedrops with improvement, but the other eye showed no improvement after the treatment, and underwent a second surgery with a cotton patch soaked in fluorouracil applied onto the supratarsal area after resection and cryotherapy. Four months after the treatment the patient presented no symptoms and GP did not recur. It is concluded that the resection and cryotherapy combined with AMT is an effective and safe treatment for VKC with GP.