Vernal Keratoconjunctivitis

Vernal keratoconjunctivitis (VKC) is allergic inflammation in the cornea and conjunctiva in your eyes. VKC happens when allergens in the air get into your eye and irritate your cornea and conjunctiva.

The cornea is a clear, dome-shaped cover on your eye. The conjunctiva is a clear membrane that covers the inside of your eyelid and the white part of your eye.

Keratoconjunctivitis is similar to pink eye. It happens when both your cornea and conjunctiva are irritated at the same time.

VKC usually affects kids and young adults. Many children grow out of it after puberty and don’t have symptoms anymore.

Vernal keratoconjunctivitis is a specific type of keratoconjunctivitis. Vernal is a Latin word that means springtime. That’s where it gets its name. It’s keratoconjunctivitis that affects your child during the spring and summer when there are lots of allergens in the air.

Symptoms of vernal keratoconjunctivitis

VKC symptoms usually happen in both eyes at the same time. They can include:

• Red eyes
• Itchy or burning eyes
• Small, hard bumps under your child’s eyelids (eye doctors call these eye cobblestones)
• Light sensitivity
• Swollen eyelids
• Watery eyes or eye discharge
• Blurry vision

You might not be able to see eye cobblestones in your child’s eyes. They might say it feels like there’s something stuck under their eyelids. Don’t try to pull their eyelids back to see cobblestoning at home. Tell your eye doctor what they’re feeling. They’ll safely examine your child’s eyes.

Vernal keratoconjunctivitis causes

Allergies cause VKC. If your child is allergic to something, their immune system overreacts to it. When particles of an allergen get in their eyes, it can lead to inflammation. Pollen and other plant allergens that are worse in spring and summer usually cause vernal keratoconjunctivitis.

VKC risk factors

Males are more likely to develop vernal keratoconjunctivitis. This disease typically affects children and young adults between the ages of 5 and 20. Your child might have a higher risk if they have certain health conditions, including:

• Seasonal allergies
• Eczema
• Asthma
• Dermatitis

Around half of kids with VKC have a biological family member with it, too. That means it may be genetic condition. Experts are still studying this possibility.

Complications of VKC

Vernal keratoconjunctivitis can get worse over time. Each episode can be more severe than the last. That’s why it’s important to get a diagnosis and treatment as soon as you notice symptoms.

It’s rare, but untreated VKC can damage your child’s eyes. The inflammation can lead to:

• Corneal ulcers
• Cataracts
• Keratoconus

Treating the inflammation will help you avoid these complications.

How doctors diagnose VKC

An eye doctor will diagnose VKC with an eye exam. Tell your eye doctor when you or your child first noticed symptoms. Let them know if symptoms seem worse at any time of year or if they come and go.

Most of the time, your eye doctor will be able to diagnose VKC by looking at your child’s eyes and learning about the symptoms. But they might collect a sample of discharge from your child’s eyes. They may swab the cobblestones under your child’s eyelids. This can help them test for signs of infections or elevated mast cells. These cells usually help fight infections. But they can also cause allergic reactions.

Vernal keratoconjunctivitis treatment

Your eye doctor will suggest treatments. Your child might need:

• Artificial tears: These are usually over-the-counter (OTC) eye drops. They lubricate your eyes. Your eye doctor will suggest the right type for your child.
• Medicated eye drops: Your child might need drops with a prescription medication in them. This could include antihistamine or corticosteroid. Your eye doctor might suggest a mast cell stabilizer. These medications calm down overactive mast cells. They might reduce the severity of VKC flares. You may be able to use over-the-counter allergy eye drops.
• Cool compresses: Placing a damp washcloth or towel on your child’s eyes can soothe itching and irritation. Tell them not to rub or press on their eyes. Gently place the compress on their eyes with no pressure.
• NSAIDs: Over-the-counter medications, like ibuprofen and aspirin, reduce inflammation. Talk to your eye doctor before using NSAIDs to manage VKC. They’ll tell you how often it’s safe for your child to take them.
• Trigger avoidance: It can be hard to avoid allergens. Especially in the spring and summer, when it feels like the air is full of them. But you can track allergy seasons. You might plan to avoid being outside when allergens you know affect your child are high. Wearing sunglasses or a hat can help them manage light sensitivity.
• A referral to an allergist: Your eye doctor may refer your child to an allergy specialist. An allergist will test your child for allergies. They’ll prescribe medications or shots to treat any allergies your child has.

When should I see my healthcare provider?

Visit a healthcare provider or eye doctor if you notice any new symptoms or changes in your child’s eyes. Especially if redness, sensitivity or other issues last for more than a few days. See an eye doctor right away if your child’s vision suddenly gets worse.

Your eye doctor will tell you how often your child will need eye exams in the future. Tell your doctor if your child starts having vernal keratoconjunctivitis symptoms more often. Or if it feels like their VKC treatments aren’t helping as much.

What can I expect if my child has vernal keratoconjunctivitis?

VKC can be annoying to manage. But the good news is that it’s usually temporary. Most kids stop having symptoms after puberty. If it doesn’t completely go away, your child will probably have fewer flares. And flares that happen after puberty are usually milder.

VKC should have less of an impact on your child’s eyes and daily routine once you find treatments that work for them. Talk to your eye doctor if it ever feels like treatments stop working.