PPT Konjungtivitis - Free download as Powerpoint Presentation .ppt /.pptx), PDF File .pdf), Text File .txt) or view presentation slides online. Vernal keratoconjunctivitis is a type of allergic conjunctivitis that usually affects both eyes, causing discomfort, imflammation and red g: konjungtivitis | Must include: konjungtivitis. There are five main types of ocular allergy: seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal Missing: konjungtivitis | Must include: konjungtivitis.
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Bulbar form- It is characterised by dusky red triangular congestion of bulbar conjunctiva in palpebral area, gelatinous thickened accumulation of tissue around limbus and presence of discrete whitish raised dots along the limbus Tranta's spots.
Mixed form- Shows the features of both palpebral and bulbar types. Such patients often give family history of other atopic diseases such as hay feverasthma or eczemaand their peripheral blood shows eosinophilia and increased serum IgE levels. Predisposing factors[ edit ] Age and sex — 4—20 years; more common in boys than girls.
Season — More common in summer. Hence, the name Spring catarrh is a misnomer. In Trantas described the limbal white dots that had been previously demonstrated by Horner. Konjungtivitis vernalGabrielides identified eosinophils in conjunctival secretions as well of the peripheral blood of VKC patients.
InTrantas characterized the spectrum of corneal changes seen in Konjungtivitis vernal . It is typically bilateral but may be asymmetric in nature.
Vernal Keratoconjunctivitis - EyeWiki
Signs The signs of VKC can be divided into conjunctival, limbal and corneal signs. Conjunctival konjungtivitis vernal include diffuse conjunctival injection and upper tarsal giant papillae. Additionally, these giant papillae can sometimes be seen near the limbus, and while relatively uncommon symblepharon formation and conjunctival fibrosis can occur .
Limbal signs include thickening and opacification of the limbal conjunctiva as well as gelatinous appearing and sometime confluent limbal papillae. Peri-limbal Horner-Trantas dots are focal white limbal dots consisting of degenerated epithelial cells and eosinophils .
Limbal disease can result in a limbal stem cell deficiency which can lead to pannus formation with corneal neovascularization .
Corneal signs vary according to the severity of the disease process . Punctate epithelial erosions or keratitis can coalesce into macro-erosions of the epithelium . Plaques containing fibrin and mucous can accumulate into macro-erosions forming Shield ulcers.
Corneal neovscularization can ensue and resolution can leave a characteristic ring-like scar [4, 7]. A waxing and konjungtivitis vernal gray-white lipid depositing in the peripheral, superficial stroma can occur and is known as pseudogerontoxon . Keratoconus has been shown to be more prominent in Konjungtivitis vernal patients as well; possibly due to increased eye rubbing of chronically irritated patients .
Differential diagnosis The main differential diagnosis to be considered is atopic keratoconjunctivitis AKC.
AKC typically has an older age of onset in the 2nd to 5th decade, as opposed to onset prior to age 10 with VKC. Additionally, AKC is typically more chronic in nature and more commonly results in scarring of the cornea and conjunctival cicatrization, whereas VKC is typically more self-limiting [4, 6].
Additional differential diagnoses to consider depending on history and physical would be seasonal allergic conjunctivitis and giant papillary conjunctivitis.
Demographics and Epidemiology VKC is a condition seen primarily in hot and dry climates most commonly in West Africa and the Mediterranean basin [1, 2]. It is thought to be relatively unusual in North America and Western Europe [6, 7].
The increased incidence in hot regions is speculated to be secondary to a higher level of pollution by pollens and various other allergens. Males are affected more than females, but konjungtivitis vernal difference becomes smaller as age increases .
It is difficult to obtain an accurate prevalence as many patients konjungtivitis vernal not present to clinics as they may have a mild form of the disease and the condition is largely self-limiting.