An observational study on the clinical picture of vernal keratoconjunctivitis at a tertiary care center in Western India

Abstract

Aim: To study the clinical profile and presence of perilimbal pigmentation in cases of vernal keratoconjunctivitis (VKC). Methods: This was an observational, cross-sectional study conducted at a tertiary eye care center in western-Maharashtra from March 2019 to February 2020. One hundred fifty-two cases of VKC were identified by history, characteristic symptomatology, and slit-lamp examination. The Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows was used. The relationship of extent of pigmentation with severity and duration of the disease was analyzed using Chi-squared test. A P value of less than 0.05 was considered significant. Results: Out of 152 cases, 79.61% were males. The mean age at presentation was 11.4 ± 5.62 years. A majority (38.82%) reported in the months of May–June. Most of them had mixed form followed closely by palpebral form. The most common symptom was itching. However, complications like focal-limbal stem-cell deficiency and shield-ulcer were seen in a few cases. Notably, the characteristic perilimbal-bulbar pigmentation was noted in 81 cases (53.29%; 95% CI 45.03%–61.42%; P < 0.0001), of which 15 had pigmentation in all the four quadrants (P = 0.0033). The extent of pigmentation corelated significantly with the severity of the disease (P < 0.0001). However, it did not correlate with the duration of the disease (P = 0.0794). Conclusion: Studies on VKC in India provide limited epidemiological data, and there has been no significant series that has explained its clinical pattern in the western part of the country. The presence of perilimbal pigmentation may be a diagnostic sign in mild VKC when signs and symptoms are subtle. This knowledge will help in early diagnosis and management and thus, help prevent sight-threatening complications of VKC.