Vernal Keratoconjunctivitis: A Systematic Review

Abstract

Vernal keratoconjunctivitis (VKC) is a chronic, bilateral corneal and conjunctival problem which typically presents in young individuals. VKC is characterized by itching, photophobia, white mucous discharge, lacrimation, foreign body sensation, and pain due to corneal involvement of shield ulcers. Vernal keratoconjunctivitis is categorized within ocular diseases. The diagnosis is clinical, as no sure biomarkers pathognomonic of the disease have yet been identified. The VKC therapy relies on different types of drugs, from antihistamines and topical steroids to cyclosporine or tacrolimus eye drops. In extremely rare cases, there is also the need for surgical treatment for the debridement of ulcers, as well as for advanced glaucoma and cataracts, caused by excessive prolonged use of steroid eye drops. We performed a systematic review of the literature, according to PRISMA guideline recommendations. We searched the PubMed database from January 2016 to June 2023. Search terms were Vernal, Vernal keratoconjunctivitis, and VKC. We initially identified 211 articles. After the screening process, 168 studies were eligible according to our criteria and were included in the review. In this study, we performed a systematic literature review to provide a comprehensive overview of currently available diagnostic methods, management of VKC, and its treatments.

Keywords: Ocular allergy; VKC; Vernal keratoconjunctivitis.

Fig. 1

Flow chart of the study selection

Fig. 2

Flow chart of VKC diagnosis studies

Fig. 3

Flow chart of VKC treatment studies

Fig. 4

Conjunctival hyperemia and Trantas dots present in VKC patients

Fig. 5

Papillae at the upper tarsal lid present in VKC patients

Fig. 6

Trantas dots present in VKC patients