Dr.Mamta Agrawal

Dr.Reshma Ramakrishnan, DR. AYUSHI CHOUDHARY

Abstract

Vernal keratoconjunctivitis(VKC) is recurrent, seasonal disorder mostly affecting young males. Shield ulcer is an uncommon manifestation of severe VKC,which affects vision.15yr male,with severe itching, foreign body sensation, redness in BE from 1wk & blurring of vision in LE from 2days. H/o similar episodes since 7yrs, exacerbating in spring.RE-papillae in upper & lower tarsal conjunctiva. LE-lid oedema, giant cobblestone papillae in upper & lower tarsal conjunctiva, & fluorescein stained epithelial defect of 3x4mm with elevated plaque of mucus & debris in central cornea.Diagnosed with BE VKC & Grade 3 shield ulcer in LE.Started on topical steroid 4 times, lubricating in BE & topical tacrolimus 0.1% BD in LE. No improvement after 3 days. Margin & base of ulcer was scraped, BCL was put on 3rd day of treatment.Follow up 1week of scraping-healing margin,BCVA of 6/60 noted. 3month BCVA was 6/9.Thus, prompt treatment & early use of immunosuppressive drugs help to prevent visual loss.