title: Vernal keratoconjunctivitis: culmination of management using immunosuppression, surgical and prosthetic therapy over quarter century.
abstract: 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.
authors.affiliation: Department of Cornea, L V Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Cornea, L V Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Anand S
authors.initials: AS
authors.lastname: Pasari
authors.affiliation: Centre for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Virender S
authors.identifier: http://orcid.org/0000-0002-8229-4158
authors.initials: VS
authors.lastname: Sangwan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones