The Insight Eye Clinic

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Vernal Keratoconjunctivitis(VKC): The signs of VKC can be divided into conjunctival, limbal and corneal signs: Conjunctival signs: include diffuse conjunctiv...al injection and upper tarsal giant papillae. These are discrete >1mm in diameter that characteristically have flattened tops which sometimes demonstrate stain with fluorescein. Additionally, these giant papillae can sometimes be seen near the limbus, and while relatively uncommon symblepharon formation and conjunctival fibrosis can occur. Limbal signs: include thickening and opacification of the limbal conjunctiva as well as gelatinous appearing and sometime confluent limbal papillae. Peri-limbal Horner-Trantas dots are focal white limbal dots consisting of degenerated epithelial cells and eosinophils. Limbal disease can result in a limbal stem cell deficiency which can lead to pannus formation with corneal neovascularization. Corneal signs: vary according to the severity of the disease process. Punctate epithelial erosions or keratitis can coalesce into macro-erosions of the epithelium. Plaques containing fibrin and mucous can accumulate into macro-erosions forming Shield ulcers. Corneal neovscularization can ensue and resolution can leave a characteristic ring-like scar. A waxing and waning gray-white lipid depositing in the peripheral, superficial stroma can occur and is known as pseudogerontoxon. Keratoconus has been shown to be more prominent in VKC patients as well; possibly due to increased eye rubbing of chronically irritated patients. https://eyewiki.org/Vernal_Keratoconjunctivitis See more