Vernal Catarrh or Spring Catarrh or Warm Weather Conjunctivitis or VKC
Definition
Vernal Catarrh is a chronic, non-contagious eye-allergy disorder that is seasonal (usually appear during the spring or warm weather) and always involves the cornea and conjunctiva, of both the eyes.
Causes of Vernal Catarrh
- Hypersensitivity or allergic reaction of the eyes to airborne allergens
- Seasonal exposure to allergens like pollen, dust, dander etc.
- Environmental factors like smoke, chemicals, and other pollutants
- Non-specific elements like wind, heat, sun etc.
- Sex hormones (oestrogen & progesterone)
Affected population
- Young children, adolescents, and teens between 3 and 25 years of age
- Boys are affected more than girls
- Dark-skinned individuals (particularly Africans & Indians)
Risk Factors of Vernal Catarrh
- Family history of allergies
- Presence of other allergy-related diseases or disorders (like allergic rhinitis, asthma, eczema)
- Warm dry weather
- Warm wet regions
- Spring-summer months
- Environmental or occupational exposure to seasonal allergens
Symptoms of Vernal Catarrh
- Redness or pink colored eye
- Excessive itching
- Eye pain and inflammation
- Gritty feeling of sand or foreign body inside the eye
- Watery discharge from eye
- Blurred vision
- Intolerance to light
Signs of Vernal Catarrh
- Inflammation of the outer membrane of the eye
- Papillae formation in eyelids
- Drooping eye lids
- Twitch
- Cobblestone-like changes appear in the upper eyelid linings (palpebral conjunctiva)
- Development of gelatinous nodule in the tissue adjacent to the cornea (limbus)
- Scarring of cornea (shield ulcers)
- Clouding of the lens (cataract)
Tests and Diagnosis for Vernal Catarrh
Swift diagnosis of VKC is very important as the longer a patient suffers from it, it’s more likely for the disease to become chronic and difficult to treat. Its diagnosis includes:
- Complete patient history evaluation especially the repetitive nature and seasonal variation of the condition
- A detailed eye examination including a slit lamp or ophthalmoscope exam
- Blood IgE and eosinophil evaluation
- Conjunctival scraping
Treatment and Drugs for Vernal Catarrh
In most of the cases, VKC usually subsides at the onset of puberty. But it is required to treat the condition soon after diagnosis to prevent its potentially blinding effect.
- The first step to manage VKC is identification of the allergen and thereafter completely avoiding its contact.
- Medication with oral or topical antihistamines and mast cell stabilizers (a non-steroid drug)
- Artificial tears and ointments
- Non-steroid anti-inflammatories (NSAIDS)
- Topical steroids
- Immunotherapy (allergy shots) in severe cases
- Cold compresses
Prognosis of Vernal Catarrh
Vernal Catarrh can be very well managed if diagnosed and treated at the earliest. Quick treatment could potentially prevent the eye damage and loss of vision, due to corneal complications associated with vernal catarrh. But if not diagnosed and treated appropriately, vernal catarrh can lead to following complications:
- Mental and emotional stress
- Corneal damage, scar, and perforation
- Loss of vision
- Bacterial or viral (herpes) infections
- Cataract
- Glaucoma
