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Vernal keratoconjunctivitis: culmination of management using immunosuppression, surgical and prosthetic therapy over quarter century
  1. Shilpa Das1,
  2. Anand S Pasari1,
  3. Virender S Sangwan2
  1. 1Department of Cornea, L V Prasad Eye Institute, Hyderabad, Telangana, India
  2. 2Centre for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Virender S Sangwan, vsangwan{at}


A 22-year-old male patient presented in 1988 with active vernal keratoconjunctivitis. He was treated with topical mast cell stabilisers and corticosteroids. Chronic inflammation despite topical treatment necessitated oral immunosuppressants. Active disease came under control with this; however, the patient gradually developed limbal stem cell deficiency. He underwent bilateral pannus resection with amniotic membrane transplantation that resulted in improved ocular surface. In 2007, patient was found to have significant bilateral posterior subcapsular cataracts and underwent bilateral cataract surgery with intraocular lens implantation with good visual outcome. In 2016, he was provided with scleral lens prosthetic device, which further improved vision. At last follow-up, more than 25 years after his initial visit, his visual acuity was 20/25 in both eyes with a stable surface. With a comprehensive approach using immunosuppression, surgical therapy and scleral lens prosthetic device, chronic vernal keratoconjunctivitis can be well managed as illustrated in this case.

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  • Contributors SD contributed in planning, conduct, reporting, conception and design, acquisition of data and interpretation of data. ASP contributed in acquisition of data, design and interpretation of data. VSS contributed in planning, conduct, conception and design and interpretation of data.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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