Limbal Vernal Keratoconjunctivitis: Prompt Treatment Can Prevent Visually Threatening Complications.

Purpose: Vernal keratoconjunctivitis is a T-cell- and IgE-mediated form of allergic ocular disease that results in itching, mucous discharge, photophobia, foreign body sensation, and other potentially debilitating symptoms. The condition typically presents in the first decade of life in males and ha...

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Publicado en:Optometry & Visual Performance Vol. 7; no. 4; pp. 213 - 221
Autores principales: Alexopoulos, Denise, Vricella, Marilyn
Formato: case study pictorial Journal Article
Publicado: Optometric Extension Program Sep2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2019
      vid: 7
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      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Limbal Vernal Keratoconjunctivitis: Prompt Treatment Can Prevent Visually Threatening Complications.
      aug:
        au:
          Alexopoulos, Denise
          Vricella, Marilyn
        affil: Illinois College of Optometry • Chicago, Illinois
      sug:
        subj:
          Conjunctivitis, Allergic Diagnosis
          Conjunctivitis, Allergic Drug Therapy
          Steroids Therapeutic Use
          Cromolyn Sodium Therapeutic Use
          Ophthalmic Solutions Therapeutic Use
          Male
          Child, Preschool
          Pruritus Etiology
          Diagnosis, Differential
          Ophthalmic Solutions Administration and Dosage
          Treatment Outcomes
          Steroids Administration and Dosage
          Cromolyn Sodium Administration and Dosage
          Child, Preschool: 2-5 years
          Male
      ab: Purpose: Vernal keratoconjunctivitis is a T-cell- and IgE-mediated form of allergic ocular disease that results in itching, mucous discharge, photophobia, foreign body sensation, and other potentially debilitating symptoms. The condition typically presents in the first decade of life in males and has a predilection for warm, dry areas. It is essential that optometrists closely evaluate the anterior segment on all patients, diagnose this condition as early as possible, and manage with age-appropriate medications. Case Report: A five-year-old African American male presented for evaluation with a history of bilateral persistent red, itchy eyes for nearly one year. Corneal evaluation revealed superior limbal concretions, known as Horner-Trantas dots, which would support the diagnosis of vernal keratoconjunctivitis even though minimal eyelid involvement was noted. After unsuccessful resolution of symptoms with compliant use of an antihistamine/mast cell stabilizer ophthalmic solution, the patient was then treated with a fluorometholone 0.1% and cromolyn sodium 4.0%, resulting in a reduction of both symptoms and clinical signs. Conclusions: Limbal Trantas dots without other signs of severe allergic ocular disease are an uncommon manifestation of vernal keratoconjunctivitis. Therefore, when a pediatric patient presents with classic allergic symptoms, it is essential to examine beyond the eyelids. Providing a more comprehensive anterior segment assessment will not only improve quality of life for these young patients, but will help prevent more serious sequelae of this atopic condition.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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