title: Clinical grading of vernal keratoconjunctivitis.
abstract: OBJECTIVE
  The purpose of the present review is to provide an overview on the clinical features of vernal keratoconjunctivitis on the basis of cases series presented in the literature. Furthermore, a new grading system of vernal keratoconjunctivitis based on the severity of the disease is proposed. Different treatment options are discussed based on the clinical grade of vernal keratoconjunctivitis.
  
  
  RESULTS
  Recent epidemiological studies on the demographic, clinical and immunologic features of vernal keratoconjunctivitis are presented. The efficacy and complications of treatments are described.
  
  
  CONCLUSIONS
  Diagnosis and treatment of patients is a challenge for ophthalmologists as no precise diagnostic criteria have been established, the pathogenesis is unclear, and antiallergic treatments are often unsuccessful. This review describes old and new concepts of vernal keratoconjunctivitis diagnosis and treatment: the clinical features, the diagnostic criteria, the common features between this and other ocular allergies and the therapeutic strategies. On the basis of this knowledge, a new grading system is introduced based on clinical signs and symptoms of ocular surface inflammation. This new grading of vernal keratoconjunctivitis may help clinicians and researchers to classify disease activity and to establish a common agreement for treatments.
authors.affiliation: Department of Ophthalmology, University of Rome Campus Bio-Medico, Rome, Italy. s.bonini@unicampus.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonini
authors.forename: Marta
authors.initials: M
authors.lastname: Sacchetti
authors.forename: Flavio
authors.initials: F
authors.lastname: Mantelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lambiase
mesh_terms: D018926:Anti-Allergic Agents / Q000276:immunology / Q000627:therapeutic use*; D003228:Conjunctiva / Q000276:immunology; D003233:Conjunctivitis, Allergic / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D009883:Ophthalmic Solutions / Q000627:therapeutic use
chemical_list: D018926:Anti-Allergic Agents; D009883:Ophthalmic Solutions; D007073:Immunoglobulin E