Clinical features of vernal keratoconjunctivitis: A population study of primary school children in Nigeria

Abstract

Objective: The objective of the study is to describe pertinent clinical features of vernal keratoconjunctivitis (VKC) seen in public primary school children in Nigeria, Africa.

Methods: A cross sectional survey of children with VKC was conducted in a population of school children using a multistage sampling method. Comprehensive eye examinations were conducted including visual acuity, refraction, anterior and posterior segment examinations, ocular adnexal examinations and symptomatic break up time (SBUT) for tear assessment.

Results: Out of 1,226 primary school children examined, 223 children had VKC. The most common complaints were itching 150 (67.3%), brownish discoloration of the eyes 132 (59.2%) and stringy mucoid discharge 109 (48.9%). The total prevalence of atopy in this population was 30%. Normal vision was seen in 223 (100%) children, while 5 (0.9%) children presented with monocular moderate visual impairment. Ptosis from VKC was seen as a significant (p < .0001) finding in the tarsal clinical type 55 (24.7%) and 60 (26.9%) right and left eyes respectively. Left eye lid chalazion was also significantly associated with tarsal type of VKC (p < .0001). Common corneal complications noted were sub epithelial scarring 22 (9.9%) and pseudogerontoxon 7 (3.1%). Symptomatic tear film break-up time of < 5 seconds was seen more frequently among children 156 (70%) with VKC even though this was not statistically significant (p = .737).

Conclusion: The clinical features of VKC is similar to most population studies, including corneal complications. Eye lid pathologies including chalazion, external hordealon and ptosis were common features seen in this population. Better primary eye care for the management of VKC in children may prevent corneal complication.