Image Question-42

What is the diagnosis?

“Contributed by Dr Kirandeep Kaur, MBBS, DNB, FPOS, FICO, MRCS Ed, MNAMS”
Treasure Island (FL): StatPearls Publishing

What is the diagnosis of Image?

A. Epidemic keratoconjunctivitis

B. Vernal keratoconjunctivitis

C. Superior limbic keratoconjunctivitis

D. Keratoconjunctivitis sicca

Vernal keratoconjunctivitis (VKC) is a recurrent, bilateral allergic inflammation of the conjunctiva.

Vernal keratoconjunctivitis (VKC) is a type of allergic conjunctivitis.

Vernal keratoconjunctivitis is a common bilateral atopic disease clinically characterized by limbal papillae having papillary, limbal, and mixed forms. 

Horner Tranta dots

Limbal papillae

Horner’s-Tranta’s dots -clumps of necrotic eosinophils, neutrophils and epithelial cells

Peri-limbal Horner-Trantas dots are focal white limbal dots consisting of degenerated epithelial cells and eosinophils.

Clinical forms of VKC

There are three clinical forms of VKC:

  1. The palpebral form with giant papillae on tarsal conjunctiva.
  2. The limbal form with Horner’s-Tranta’s dots
  3. A mixed form combining the two described before

Vernal Keratoconjunctivitis Signs

Signs consist of inflammation of the mucous membrane lining the inside of the eyelid (conjunctiva) and the outer coat of the eyeball (sclera); hard, cobblestone-like bumps (papillae) on the upper eyelid; and stringy or mucous discharge.

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