Information on the following diseases can be found in the Related Disorders section of this report:

• Conjunctivitis (Pink Eye)

Vernal keratoconjunctivitis symptoms include inflammation of the outer membrane of the eye. This causes the eyes to become red and may cause blurred vision. The eyes become sensitive to light and itch intensely. Usually both eyes are affected, and cobblestone-like changes appear in the upper eyelid linings (palpebral conjunctiva). In other cases, a gelatinous nodule may develop in the tissue adjacent to the cornea (limbus). In very severe cases, the corneas may scar (shield ulcers) leading to temporarily or permanently reduced vision.
.

The cause of Vernal Keratonconjunctivitis is a hypersensitivity or allergic reaction of the eyes to airborne allergens.

Onset of vernal keratoconjunctivitis typically occurs between ages 3 and 25 years. The disorder appears to affect more males than females. It occurs most often during the spring or summer.
.

Symptoms of the following disorder can be similar to those of vernal keratoconjunctivitis. Comparisons may be useful for a differential diagnosis.

Conjunctivitis or "pink eye" is caused by an infection of the outer lining of the eye and eyelids from bacteria or viruses. The eyes become red and irritated with a sandy or burning feeling. The disease may follow a cold or sore throat, and is most common in children. Sticky pus is visible in the eye and can cause the eyelids to stick together. Pink eye is highly contagious.

Treatment of vernal keratoconjunctivitis is symptomatic and supportive. If the agent that causes the allergy is identified, it should, of course, be avoided if possible. Cold compresses and artifical tears and ointments soothe, lubricate and dilute the antigen. Topical antihistamines producing constriction of the blood vessels and ducts may help. Mast-cell stabilizers may be useful before a flare-up of the disorder or may help control a flare-up, but do little to reduce the symptoms of VKC. Non-steroid anti-inflammatories (NSAIDS) may relieve symptoms in moderate cases but topical steroids should be reserved for more severe cases.

The orphan product lodoxamide tromethamine (Alomide Ophthalmic Solution) has been approved for treatment of vernal keratoconjunctivitis. The product is manufactured by:

Alcon Laboratories
6201 South Freeway
Ft. Worth, TX 76134

The drug cromolyn sodium is now being used in the treatment of ocular allergies such as vernal keratoconjunctivitis, as well. The orphan drug Levocabastine has also been approved by the FDA for the treatment of this disorder. For more information on this drug, physicians may contact:

Iolab Pharmaceuticals
500 Iolab Drive
Claremont, CA 91711
.

Beers MH, Berkow R, eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:714-16, 1050.

Berkow R., ed. The Merck Manual-Home Edition. Whitehouse Station, NJ: Merck Research Laboratories; 1997:826-27.

Larson DE, ed. Mayo Clinic Family Health Book. New York, NY: William Morrow and Company, Inc; 1996:542-43.

REVIEW ARTICLES
Leonardi A, Secchi AG. Vernal keratoconjunctivitis. Int Ophthalmol Clin. 2003;43:41-58.

Bielory L, Mongia A. Current Opinion of immunotherapy for ocular allergy. Curr Opin Allergy Clin Immunol. 2002;2:447-52.

Bielory L Kempuraj D, Theoharides T. Topical immunopharmacology of ocular allergies. Curr Opin Allergy Clin Immunol. 2002;2:435-45.

Trocme SD, Sra KK. Spectrum of ocular allergy. Curr Opin Allergy Clin Immunol. 2002;2:423-27.

Friedlander MH. Conjunctival provocation testing: overview of recent clinical trials in ocular allergy.. Curr Opin Allergy Clin Immunol. 2002;2:413-17.

FROM THE INTERNET
M-Eye Conditions. University of Michigan, Kellogg Eye Center. Vernal Keratoconjunctivitis. nd. 2pp
www.kellogg.umich.eu/conditions/allergies/vernal.html

EyeMDLink. Vernal Keratoconjunctivitis. 2002:2pp.
www.eyemdlink.com/Conditionasp?conditionID=450

Auckland Allergy Clinic. Allergic Conjunctivitis. nd. 6pp.
www.allergyclinic.co.nz/guides/9.html

Schmid KL, Swann PG. Vernal Keratoconjunctivitis: Signs, symptoms and therapeutic management. Ot. February 23, 2001:3pp.
www.optometry.co.uk

Handbook of Ocular Disease Management. Vernal keratoconjunctivitis (VKC). nd. 2pp.
www.revoptom.com/handbook/oct02_sec2_3.htm

Handbook of Ocular Disease Management. Allergic conjunctivitis & Vernal Keratocon-junctivitis (VKC). nd. 3pp.
www.revoptom.com/handbook/SECT2A.HTM