A Severe Aspect of Pediatric Ocular Allergy to Recognize: Vernal Keratoconjunctivitis

Aim: To determine the clinical features of vernal keratoconjunctivitis and to evaluate the safety and the efficacy of the medical treatment on clinical grades. Material and Method: All patients with vernal keratoconjunctivitis who had been treated with mast-cell stabilizers, antihistamines and artificial tear drops previously were enrolled in the study. Topical steroids were added during recurrences, were tapered and discontinued according to the clinical improvement. Topical cyclosporin 0.05% four times daily was used additionally in cases of inadequate response to treatment or evident steroid dependance. Main outcome measures were the clinical features, change of clinical grades, response to treatment, rate of recurrences and side effects of the eyedrops. Results: Twenty patients (13 males, 7 females) with vernal keratoconjunctivitis in different severity scales were included. The median age of the patients was 10 (9-11) years. The median follow-up time was 35 (15-56) months. Ten patients received topical cyclosporine. The rate of recurrences was similar in patients who received topical cyclosporine compared to those who were followed with topical steroids. (p=0.17) No severe adverse reaction to any of the formulations was seen. Discussion: Topical 0.05% cyclosporin is safe and effective for the treatment of vernal keratoconjunctivitis as a steroid sparing agent. It helps to obtain good clinical response without serious adverse effects and provides improvement on the clinical grades.