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Vernal conjunctivitis

 

Vernal conjunctivitis is long-term (chronic) swelling (inflammation) of the outer lining of the eyes. It is due to an allergic reaction.

Causes

Vernal conjunctivitis often occurs in people with a strong family history of allergies. These may include allergic rhinitis, asthma, and eczema. It is most common in young males, and most often occurs during the spring and summer.

Symptoms

 

Symptoms include:

  • Burning eyes
  • Discomfort in bright light (photophobia)
  • Itching eyes
  • The area around the cornea where the white of the eye and the cornea meet (limbus) may become rough and swollen
  • The inside of the eyelids (most often the upper ones) may become rough and covered with bumps and a white mucus
  • Watering eyes

 

Exams and Tests

 

The health care provider will perform an eye exam.

 

Treatment

 

Avoid rubbing the eyes because this can irritate them more.

Cold compresses (a clean cloth soaked in cold water and then placed over the closed eyes) may be soothing.

Lubricating drops may also help soothe the eye.

If home-care measures do not help, you may need to be treated by your health care provider. Treatment may include:

  • Antihistamine or anti-inflammatory drops that are placed into the eye
  • Eye drops that prevent a type of white blood cell called mast cells from releasing histamine (may help prevent future attacks)
  • Mild steroids that are applied directly to the surface of the eye (for severe reactions)

Recent research suggests that a mild form of cyclosporine, which is an anti-cancer drug, may be helpful for acute episodes. It may also help prevent recurrences.

 

Outlook (Prognosis)

 

The condition continues over time (is chronic). It gets worse during certain seasons of the year, most often in the spring and summer. Treatment may provide relief.

 

Possible Complications

 

Complications may include:

  • Continuing discomfort
  • Reduced vision
  • Scarring of cornea

 

When to Contact a Medical Professional

 

Call your provider if your symptoms continue or get worse.

 

Prevention

 

Using air conditioning or moving to a cooler climate may help prevent the problem from getting worse in the future.

 

 

References

Barney NP, Graziano FM, Cook EB, Stahl JL. Allergic and immunologic diseases of the eye. In: Adkinson NF, Bochner BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 39.

Boguniewicz M, Cho CB, Sicherer SH. Occular allergies. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 1477.

Hernandez-Trujillo V, Riley E, Rudnick C. Allergy. In: Rakel RE, Rakel D, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 19.

Lambiase A, Leonardi A, Sacchetti M, et al. Topical cyclosporine prevents seasonal recurrences of vernal keratoconjunctivitis in a randomized, double-masked, controlled 2-year study. J Allergy Clin Immunol 2011;128(4):896-897. PMID: 21868078 www.ncbi.nlm.nih.gov/pubmed/21868078.

Rubenstein JB, Tannan A. Allergic conjunctivitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4.7.

Stock EL. Vernal keratoconjunctivitis. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2013:vol 4, chap 9.

 
  • Eye

    Eye - illustration

    The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

    Eye

    illustration

    • Eye

      Eye - illustration

      The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

      Eye

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Vernal conjunctivitis

           

             

            Review Date: 3/15/2016

            Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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