title: Vernal shield ulcers treated with frequently installed topical cyclosporine 0.05% eyedrops.
abstract: OBJECTIVE
  To report on the beneficial results of an intense regimen of 0.05% cyclosporine eye drops, eight times a day in patients with therapy resistant vernal shield ulcers.
  
  
  METHODS
  Case cohort of four eyes of three male children with vernal keratoconjunctivitis complicated by shield ulcers, who were treated with frequent cyclosporine 0.05% eye drops and observed for up to 5 years.
  
  
  RESULTS
  Quick resolution of the shield ulcers and complete re-epithelialization within 14-25 days was observed after adding intensive treatment with cyclosporine 0.05% to regular anti-inflammatory, histamine blocking, and surgical therapy. In one patient, additional scraping of the bottom of the ulcer was needed.
  
  
  CONCLUSIONS
  In patients with vernal shield ulcers, frequent installation of low-concentration cyclosporine eye drops seems to have a promising therapeutical value.
authors.affiliation: Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. westland.tim@gmail.com.|Department of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. westland.tim@gmail.com.
authors.forename: Tim
authors.identifier: http://orcid.org/0000-0002-7872-5664
authors.initials: T
authors.lastname: Westland
authors.affiliation: Department of Ophthalmology, Oogziekenhuis Zonnestraal, Amsterdam, The Netherlands.
authors.forename: Eliza K
authors.initials: EK
authors.lastname: Patryn
authors.affiliation: Department of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Carla P
authors.initials: CP
authors.lastname: Nieuwendaal
authors.affiliation: Department of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Ivanka J E
authors.initials: IJE
authors.lastname: van der Meulen
authors.affiliation: Department of Ophthalmology, Oogziekenhuis Zonnestraal, Amsterdam, The Netherlands.|Department of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Mourits
authors.affiliation: Department of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.|Retina Total Eye Care, Driebergen, The Netherlands.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lapid-Gortzak
mesh_terms: D000293:Adolescent; D002648:Child; D003228:Conjunctiva / Q000473:pathology*; D003233:Conjunctivitis, Allergic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003315:Cornea / Q000473:pathology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016572:Cyclosporine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity
chemical_list: D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine
keywords: Allergy; Cyclosporine A; Immunomodulation; Shield ulcer; Vernal catarrh; Vernal keratoconjunctivitis