Vernal Keratoconjunctivitis (VKC)

Vernal Keratoconjunctivitis (VKC)
		SYMPTOMS	Significant itch \| Discharge
		SIGNS	Ropy discharge \| Limbal papillae \| large conjunctival papillae in upper eyelid (cobblestone papillae) \| Superior corneal ulcer (shield ulcer) \| Horner-Trantas dots
		WORK-UP	Thorough history. Slit lamp examination
		TREATMENT
			Cool compresses \| Avoidance of allergen(s)
			Topical steroid drops to start: Pred Forte 1gtt OU qid x 2 \| Lotemax 1gtt OU qid x 2 weeks \| Followed by milder anti-inflammatory eye drops: Pataday 1 gtt OU qAM \| Zaditor 1 gtt OU bid \| Restasis 1 gtt OU bid
			Consider adding a topical antibiotic drop if a shield ulcer is present (i.e. polytrim 1 gtt qid in affected eye).
		FOLLOW-UP	Every 2 weeks, or every 2-3 days of shield ulcer is present
		ADDITIONAL LAB \| TESTS	If severe, could consider an allergy panel
		ETIOLOGY	A number of allergens can cause VKC
		DIFFERENTIAL DX	Giant papillary conjunctivitis \| Allergic conjunctivitis \| Atopic keratoconjunctivitis (AKC) \| Dry eye syndrome \| Episcleritis
NOTES	Usually self-limiting \| Usually affects young males \| Best to treat before allergy season starts \| Strong association with atopy
	AKC is very similar to VKC but usually present in Adults and year-round