This document presents a case study of vernal keratoconjunctivitis (VKC) in a 6-year-old male patient. VKC is a chronic inflammation of the conjunctiva that is more common in young boys. The patient presented with redness, itching, irritation and photosensitivity of the eyes. Examination revealed limbal and palpebral VKC. The patient was diagnosed with VKC and prescribed a tapering regimen of topical medications including moxifloxacin, dexamethasone, hydroxypropylmethyl cellulose, ketorolac tromethamine, olopatadine, and polymyxin B with chloramphenicol and dexamethasone. The patient

1. CASE PRESENTATION
ON
VERNAL KERATO CONJUNCTIVITIS
(VKC)
PRESENTED BY:
NUTHAN.V
Y12PHD0430
VI PHARM-D

2. INTRODUCTION
• VKC is a bilateral chronic inflammation of the conjunctiva of the eye.
• It is more common in young boys. The disease affects children between 3 to 16
years of age though it may appear earlier than that and continue into adulthood.
• In the majority of cases, symptoms resolve at puberty.
• Limbal and palpebral vernal keratoconjunctivitis (VKC) are usually considered to
be different expressions of the same disease.

3. • Limbal VKC was distinguished from palpebral VKC by the development of
papillae at the limbus. Whereas, the palpebral form was distinguished by
presence of giant papillae on the upper tarsal conjunctiva.
• Patients showing both giant papillae and limbal papillae were classified as mixed.
• Although Horner-Trantas's dots are commonly associated with limbal papillae
they were not considered pathognomonic of limbal VKC because they have been
frequently reported at other sites.
INTRODUCTION…

4. • 1. This may start as
thickening &
opacification of limbus,
follicles, mucoid
nodules & trantas dots
can be observed.
• 2. Papillary
hypertrophy on
superior tarsus was
observed.
• 3. Papillae having
polygonal appearance
resembling “Cobbler
stones”.
1. 2.
3.
Limbal VKC & Palpebral
VKC

5. PATIENT DEMOGRAPHICS:
• Age: 6 years
• Sex: Male
• Unit: Outpatient
• Weight: 20 kgs
• DOA : 6-9-17

6. CHIEF COMPLAINTS:
Redness of eyes since last night,
Itching, Irritation, Photosensitivity
NO EVIDENCE OF PMH/O

7. EXAMINATIONS
Detailed eye examination including:
A slit lamp (usually performed during
eye checkups to look for any diseases
or abnormalities in the anterior portion
of the eye, which includes the eyelids,
lashes, lens, conjunctiva, cornea, and
iris) or
ophthalmoscope(Fundoscopy to see
inside the fundus of the eye and other
structures) examination

8. PROVISIONAL DIAGNOSIS
VERNAL KERATO
CONJUNCTIVITS

9. PLAN FOR THERAPY
DRUG DOSE FREQUENCY DURATION
Opth. Moxifloxacin +
Dexamethasone
5mg/ 1mg 5 times a day
for a week
followed by tapering
frequency of dose
Opth. Hydroxypropylmethyl
cellulose
0.3% w/v 3 times a day For 6 months
Opth. Ketorolac tromethamine+
Olopatadine
4mg/ 1mg 2 times a day For 6 months
Oint. Polymyxin B+
Chloramphenicol+Dexamethaso
ne
1000 units/
10mg/ 1mg
At night For 2 weeks

10. Patient counselling
Patient guardian was counselled to :
• Use cold water to wash both the eyes.
• Using goggles to cover the eyes.
• Use Cold compress & ice packs to relieve pain and discomfort.
• Avoid touching eyes with hands.