Clinical course and treatment of vernal conjunctivitis (author's transl)

Abstract

Vernal conjunctivitis is caused by a hyperplasia of connective tissue. On the upper eyelid, vernal conjunctivitis may manifest in a mild or serious form. The mild form is characterized by isolated small warts on the upper edge of the tarsus. In such cases the conjunctiva tarsi may exhibit increased vascularization with biomicroscopically demonstrable, subepithelial, reticular density of the connective tissue. In the chronic tarsal form large cobble-stone proliferations (condylomata) develop, which may result in a keratopathy (disk-shaped erosion). The association of vernal conjunctivitis with other symptoms of atopy (neurodermitis constitutionalis, bronchial asthma) is indicative of common etiopathogenetic relationships. The serum antibodies present in atopy are immunoglobulins of the E type. The differential diagnosis of vernal conjunctivitis comprises trachoma, paratrachoma, conjunctival folliculosis, and chalaziosis. Therapy consists of a local application of corticosteroid containing drops and ointments, drops containing vasoconstringents and antihistaminics, and of Opticrom eyedrops. In the inveterate bulbar type, subconjunctival injections of corticosteroids are indicated. Frequently, vernal conjunctivitis ceases after onset of puberty. When large and coarse condylomata on the upper eyelid occur together with long-lasting complaints and corneal complications, combined tarsal extirpations after Kuhnt is the method of choice.