Vernal keratoconjunctivitis: The burden of being allergic

Background: Vernal keratoconjunctivitis (VKC) is a chronic inflammatory eye condition predominantly affecting children. Despite its varied clinical manifestations, VKC poses challenges in diagnosis and management because of its multifactorial nature, potentially involving allergic sensitization and comorbidities. Objective: The purpose of this study was to comprehensively assess VKC, focusing on the possible effect of allergic sensitization on the clinical form, severity, and quality of life of pediatric patients with VKC. Methods: In this retrospective study, encompassing 248 children aged 5 to 12 diagnosed with VKC, clinical data, ophthalmologic assessments, and quality-of-life metrics were systematically collected. Patients were divided into sensitized and nonsensitized groups according to allergy investigations. Comprehensive evaluations included clinical history, symptom scoring, Bonini grading for severity, allergen tests, blood examinations, and ophthalmologic examinations. Results: Among the enrolled patients, a prevalence of nonsensitized cases (56%) emerged. Both sensitized and nonsensitized groups displayed similar demographic profiles and clinical forms of VKC. A significantly higher occurrence of rhinitis and asthma was observed in the sensitized group. No significant differences were found in ophthalmologic and hematologic parameters between the 2 groups. Despite this, sensitized patients exhibited a significantly higher impact on quality of life, as indicated by QUICK questionnaire scores. Conclusion: The study underscores the importance of comprehensive allergy assessments during VKC diagnosis, suggesting potential associations between sensitization and atopic comorbidities impacting patients’ quality of life. Future investigations into environmental factors, specific allergens, and treatment response are pivotal for a holistic understanding of VKC's implications for pediatric patients’ well-being.