Corneal neovascularization in childhood keratitis

Abstract

ABSTRACTIntroduction: Cornea clarity is essential for optimal vision at any age. In childhood, loss of corneal transparency may also lead to amblyopia. Thus, proper management of the conditions that lead to corneal scarring and neovascularization in children is of utmost importance.Areas covered: Herein, we review the pathophysiology of the main causes of corneal inflammation, scarring and neovascularization in childhood. A review of the literature was performed using the keywords ‘herpetic keratitis’, ‘blepharokeratoconjunctivitis’, ‘ocular rosacea’, ‘phlyctenular conjunctivitis’, ‘vernal keratoconjunctivitis’, and ‘corneal neovascularization’ in combination with the words ‘children’ or ‘childhood’.Expert commentary: Regardless of the underlying cause of the inflammatory stimulus – viral infection, meibomian gland secretions, atopy – scarring and neovascularization occur when expression of pro-angiogenic factors outweighs that of anti-angiogenic ones. Proper control of the inflammation will restore the equilibrium between pro- and anti-angiogenic enzymes and cytokines and, in turn, limit the resulting scarring and neovessel formation. Early diagnosis and therapy for herpetic infection, blepharokeratoconjunctivitis, and atopic disease can preserve and/or restore corneal clarity in childhood keratitis.