SEQUELS OF SEVERE VERNAL KERATOCONJUNCTIVITIS (KCV): ABOUT A CASE

The aim of our study is to show the value of an early diagnosis of vernal keratoconjunctivitis and rapid management to avoid the major consequences of this pathology on the eye and the psychic.

Pediatric ophtalmology department. Hospital 20 august 1953. Casablanca. Morocco.

Our study concerns a single case of a young patient of 15 years, resident in a rural environment, having as history of itching and redness of the eye since childhood never having consulted an ophthalmologist. Having consulted for a major, disabling photophobia, with tearing and significant ocular pruritus, associated with a decline in bilateral visual acuity affecting the patient's education.

The ophthalmological examination shows a visual acuity of 3/10 in the right eye and 2/10 in the left eye. At the appendages there is conjunctival hyperaemia, giant papillae and nodules of limbic Trantas at the level of both eyes. At the anterior segment, a raised vernal plate occupies the upper 1/3 of the cornea, with 360° neovessels and a clear lens at the level of both eyes. The fluorescein test results in a diffuse superficial punctuated keratitis in both eyes. It is a bilateral vernal keratoconjunctivitis of mixed form (palpebral and limbic) complicated of corneal involvement stage 3 according to the Cameron classification. Therapeutic management: Scraping of the plaque at the scarifier in the operating room under topical anesthesia, anti-allergic treatment (Antihistamine and Mastocytic Antidgranulant), eye wash solutions, Wetting and healing corneal agents without preservatives and corticosteroids strengthened local then ciclosporin eye drops 1%:2 drop/ day with an allergy assessment. The evolution was marked by a regression of pruritus and photophobia with decrease of conjunctival hyperaemia with persistence of a corneal opacity sequellary associated with neovascularization.

Vernal keratoconjunctivitis is a clinical form of eye allergy that can induce major visual complications. The disabling functional signs of inflammatory outbreaks have a major impact on the lives of children and parents. It can be a source of drop-out, anxiety and behavioural disorders, hence the interest of psychological support for the patient.