Profile of Vernal Keratoconjuctivitis paediatric age patients in central India
Authors: Ojha Sushil, Tandon Anupama, Sharma Reena, Sami Ifsa, Singh Sonali, Saraswat Neeraj, Shukla Dipendra
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Objective: To study the profile of the VKC patients in central India.
Method: Prospective cross sectional study includes 186 cases of paediatric age group (age less than 16 years) suffering from Vernal Keratoconjunctivitis. Both male and female children were included. The things assessed includes clinical features and course of disease like recurrence or increase in severity even after starting treatment.
Results: The total number of 186 cases of vernal keratoconjunctivitis were studied. Mean age of the patients was 10.40 ± 5.78 years. Out of these 123 (66.13%) were male and 63 were female, with a male: female ratio of around 2. Male children presented at earlier age than female may be because of more care of male child in rural India than female child. All patients in the present study had bilateral involvement. Most of the children were from age of 11-15 years ( 120 patients, 64.52%), followed by 6-10 years (54 patients, 29.03%) and only 12 patients (6.45%) of age less than 5 years. The most common presenting complain was itching (160 patients, 86.02%), followed by redness (128 patients, 68.81%), watering (120 patients, 64.52%), ropy discharge (67 patients, 36.02%) and photophobia 963 patients, 33.87%). On clinical examination most common sign was papillae (140 patients, 75.27%), followed by muddy sclera(83 patients,44.62%), gelatinous limbal opacification with thickening( 60 patients, 32.25%), shield ulcer( 11 patients, 5.91%), and advanced glaucomatous optic atrophy (4 patients, 2.15%). The systematic comparison of present study with the study done by Stafeno Bonini et al in 2000.
Conclusions: Vernal Keratoconjunctivitis (VKC) is chronic ocular surface inflammatory condition mediated by type I Hypersensitivity reaction. The inflammation is mediated by Eosinophils, Ig E antibody, non- Ig E mechanisms, mixed mechanisms, genetic mechanisms and age-sex related effects. The VKC has a good prognosis in early stages but in chronic recurrent disease blinding complications can occur due to corneal scarring and advanced steroid induced glaucoma. So, by knowing the regional natural history of the disease will help in early intervention and will help in preventing blinding complications. It is necessary to create awareness for proper management of VKC patients of central India.