Vernal ­keratoconjunctivitis­ in ­children

Introduction
To evaluate the course of palpebral type of vernal keratoconjunctivitis (VKC) and relation of the number of recurrences per year, to patients age and to estimate the frequency of irreversible corneal transparency changes and visual acuity decrease.

Material and methods
There were 34 eyes of 17 children, 13 boys (76,4%) included 2 brothers and 4 girls. The age of patients was from 5 to 14 years, mean 9.1. All patients were hospitalized because of pathological corneal changes. Follow up from 2 to 13 years (mean 8.4). The number of recurrences ranged from 2 to 5 per year and there was not correlation between age of children and frequency of episodes.

Results
We have observed punctate keratopathy (79.14% of cases) and corneal ulcers (26.5% of cases). In 25 eyes of 13 patients cryocoagulation and/or excision of giant palpebral papillae were done. Visual acuity ranged from 0.01 to 1.0 and mean value before treatment was 0.879 ± 0.09 and after 0.884 ± 0.10. The difference was not statistically significant (p = 0.878).

Conclusions
1. The course of VKC is recurrent, the number of recurrences per year does not depend on the age of patients, but is correlated with giant papillae of palpebral conjunctiva presence. 2. Large papillae should be excised, in order to make the healing of cornea quicker. 3. Permanent visual function decreasing is not frequent because partial leucoma is localized at the periphery of cornea.