Association of Vernal Keratoconjunctivitis (VKC) with Keratoconus in Patients Presenting to Ophthalmology Clinics of Rawal Institute of Health Sciences, Pakistan
DOI:
https://doi.org/10.51253/pafmj.v74i2.8596Keywords:
Keratoconus, Vernal Keratoconjunctivitis, dioptersAbstract
Objective: To establish an association of vernal keratoconjunctivitis with keratoconus.
Study Design: cross-sectional study.
Place and Duration of Study: Department of Ophthalmology, Rawal Institute of Health Sciences, Rawalpindi Pakistanv from Dec 2019 to Feb 2020.
Methodology: Patients with an age less than 16 years and a history of VKC were included. Ulcers or scars, systemic
connective tissues, and blue sclera were excluded. Follow-up after two weeks and later three months was conducted. Individuals with K readings of less than 45 diopters were considered normal.
Results: Among the 135 individuals enrolled in the study, more males 95(70%) than women 40(30%) were observed. The study also showed more individuals from age groups 1-10 years of age 107(79%). After three months, biomicroscopic findings and corneal topography (Oculus Pentacam HR) revealed that 20 individuals (14.8%) developed keratoconus (p˂0.001). The disease severity, periodicity, and eye rubbing lead to the development of keratoconus.
Conclusion: Pediatric keratoconus deteriorates faster than adults, and the management differs for various reasons, such as faster progression and advanced stage of disease at the time of diagnosis. It burdens society as it influences children's quality of life and development. Hence, predisposing conditions such as Vernal keratoconjunctivitis need early diagnosis, recognition of progression, and appropriate intervention to prevent vision-threatening conditions such as keratoconus.
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References
Feizi S, Javadi MA, Alemzadeh-Ansari M, Arabi A, Shahraki T,
Kheirkhah A. Management of corneal complications in vernal
keratoconjunctivitis: A review. Ocul Surf 2021; 19: 282-289.
https://doi.org/10.1016/j.jtos.2020.10.005
Arif AS, Aaqil B, Siddiqui A, Nazneen Z, Farooq U. Corneal
Complications And Visual Impairment In Vernal
Keratoconjunctivitis Patients. J Ayub Med Coll Abbottabad 2017;
(1): 58-60.
Singhal D, Sahay P, Maharana PK, Raj N, Sharma N, Titiyal JS.
Vernal Keratoconjunctivitis. SurvOphthalmol 2019; 64(3): 289-
https://doi.org/10.1016/j.survophthal.2018.12.001
Leonardi A, Doan S, Amrane M, Ismail D, Montero J, Németh J,
et al; VEKTIS Study Group. A Randomized, Controlled Trial of
Cyclosporine A Cationic Emulsion in Pediatric Vernal
Keratoconjunctivitis: The VEKTIS Study. Ophthalmology 2019;
(5): 671-681. https://doi.org/10.1016/j.ophtha.2018.12.027
Babineaux S, Blalock S, Katz J. Epidemiology of Vernal
Keratoconjunctivitis in the United States: A Claims Data
Analysis. Invest Ophthalmol Vis Sci 2020;61(7):4592.
Zicari AM, Capata G, Nebbioso M, De Castro G, Midulla F,
Leonardi L, et al. Vernal Keratoconjunctivitis: an update focused
on clinical grading system. Ital J Pediatr 2019; 45(1): 64.
https://doi.org/10.1186/s13052-019-0656-4
Godefrooij DA, de Wit GA, Uiterwaal CS, Imhof SM, Wisse RP.
Age-specific Incidence and Prevalence of Keratoconus: A
Nationwide Registration Study. Am J Ophthalmol 2017; 175: 169-
https://doi.org/10.1016/j.ajo.2016.12.015
Hos D, Le VNH, Hellmich M, Siebelmann S, Roters S, Bachmann
BO, et al. Risk of Corneal Graft Rejection After High-risk
Keratoplasty Following Fine-needle Vessel Coagulation of
Corneal Neovascularization Combined With Bevacizumab: A
Pilot Study. Transplant Direct 2019; 5(5): e452.
https://doi.org/10.1097%2FTXD.0000000000000894
Krachmer JH, Feder RS, Belin MW. Keratoconus and related
noninflammatory corneal thinning disorders. SurvOphthalmol
; 28(4): 293-322.
https://doi.org/10.1016/0039-6257(84)90094-8
Hashemi H, Heydarian S, Hooshmand E, Saatchi M, Yekta A,
Aghamirsalim M, et al. The Prevalence and Risk Factors for
Keratoconus: A Systematic Review and Meta-Analysis. Cornea
; 39(2): 263-270.
https://doi.org/10.1097/ico.0000000000002150
Gupta Y, Sharma N, Maharana PK, Saxena R, Sinha R, Agarwal
T, et al. Pediatric Keratoconus: Topographic, Biomechanical and
Aberrometric Characteristics. Am J Ophthalmol. 2021; 225: 69-75.
https://doi.org/10.1016/j.ajo.2020.12.020
Mahmoud S, El-Massry A, Goweida MB, Ahmed I. Pediatric
Keratoconus in A Tertiary Eye Center in Alexandria: A Crosssectional Study. Ophthalmic Epidemiol 2022; 29(1): 49-56.
https://doi.org/10.1080/09286586.2021.1892154.
Moschos MM, Gouliopoulos NS, Kalogeropoulos C, Androudi S,
Kitsos G, Ladas D, et al. Psychological Aspects and Depression in
Patients with Symptomatic Keratoconus. J Ophthalmol 2018;
: 7314308. https://doi.org/10.1155%2F2018%2F7314308
Shehadeh MM, Diakonis VF, Jalil SA, Younis R, Qadoumi J, AlLabadi L, et al. Prevalence of Keratoconus Among a Palestinian
Tertiary Student Population. Open Ophthalmol J 2015; 9: 172-
https://doi.org/10.2174/1874364101509010172
Umale RH, Khan MA, Moulick PS, Gupta S, Shankar S, Sati A, et
al. A clinical study to describe the corneal topographic pattern
and estimation of the prevalence of keratoconus among
diagnosed cases of vernal keratoconjunctivitis. Med J Armed
Forces India 2019; 75(4): 424-428.
https://doi.org/10.1016%2Fj.mjafi.2018.07.012
Alrobaian M, Elsayed M, Alotaibi AK, AlHarbi M, May W, Stone
DU, et al. Safety and efficacy of corneal cross-linking in pediatric
patients with keratoconus and vernal keratoconjunctivitis.
Middle East Afr J Ophthalmol 2019; 26(2): 95-100.
https://doi.org/10.4103%2Fmeajo.MEAJO_240_18
Naderan M, Rajabi MT, Zarrinbakhsh P, Bakhshi A. Effect of
Allergic Diseases on Keratoconus Severity. OculImmunol
Inflamm 2017; 25(3): 418-423.
https://doi.org/10.3109/09273948.2016.1145697
Irfan M, Khan SAR, Jan W, Zeeshan, Khalid K. Frequency of
different types of vernal keratoconjunctivitis in patients
presenting to a tertiary care hospital. J Postgrad Med Inst 2020;
(4): 227-230.
Ben-Eli H, Erdinest N, Solomon A. Pathogenesis and
complications of chronic eye rubbing in ocular allergy. Curr
Opin Allergy Clin Immunol 2019; 19(5): 526-534.
https://doi.org/10.1097/aci.0000000000000571
Rahman A, Rahman S, Faridi J. Keratoconus: early onset, the
worst prognosis, eye rubbing and hand-dominance. Adv
Ophthalmol Vis Syst 2020; 10(4): 79-84.
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