Vernal conjunctivitis

Definition

Vernal conjunctivitis is a seasonal inflammation of the outer lining of the eyes (conjunctivitis), thought to be due to an allergic reaction.

Causes, incidence, and risk factors

Vernal conjunctivitis is thought to be caused by allergic reactions. Often, it occurs in people with a strong family history of allergies. It is most common during the spring and summer.

The condition is characterized by itchy, watery eyes. Affected people may experience burning and discomfort when they are in bright light (photophobia). The underside of the eyelids may become roughened and covered with bumps and a whitish mucus, giving them a cobblestone appearance.

Tissue around the cornea where the white of the eye and the cornea meet (limbus) may become roughened and inflamed. If this tissue extends onto the cornea, it may cause scarring and decreased vision.

Symptoms

• itching eyes
  
• burning eyes
  
• watering eyes
  
• discomfort in bright light (photophobia)
  
• symptoms are seasonal

Horner-Trantas dots (chalky mounds of conjunctiva around the limbus) may develop from collections of eosinophils.

Large bumps (papillae) on the underside of the eyelids have a characteristic cobblestone appearance.

Occasionally, the cornea develops a noninfectious ulcer from the abrasive effect of the large papillae.

Treatment

Avoid rubbing the eyes, as this further irritates them. Cold compresses (a clean cloth soaked in cold water and then placed over the eyes) may be soothing. Topical corticosteroids may be prescribed to reduce the inflammation. Cromolyn sodium or antihistamine drops may also be prescribed.

Expectations (prognosis)

The condition is persistent, worsening during certain seasons of the year. Treatment may provide relief.

Complications

• scarring of cornea
  
• reduced vision
  
• persistent discomfort

Prevention

Use of air conditioning or moving to a cooler climate may help to prevent future exacerbation of this problem.

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