Vernal Conjuctivitis

Vernal or allergic conjunctivitis can be explained simply as a chronic swelling of the outer lining of the eyes due to an allergic reaction. It is an atopic condition of the external surface of the eye, characteristically affecting young males in hot dry climates in a seasonal manner. Vernal Conjunctivitis is also called Vernal Keratoconjunctivitis and it is classified as a member of the group of allergic conjuctivitis including seasonal and perennial, atopic and giant pupillary conjunctivitis.

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It was considered an expression of a classical type I of IgE-mediated hypersensitivity reaction at the conjunctiva level.Over time, it has been shown that the pathogenesis of vernal keratoconjunctivitis is more complex than a type 1 hypersensitivity reaction. Despite the numerous scientific breakthroughs, the precise role of genetic predisposition and environmental factors in vernal conjunctivitis is not fully understood to the present day. It is typically not a blinding condition however, visual impairment may occur if the cornea is involved.

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Demographics
Vernal Keratoconjunctivitis is commonly seen in hot and dry climates, like West Africa and the Mediterranean basin. It can be seen in the Middle East, Japan, India and South America as well. This increase in prevalence in hotter regions has been attributed to higher levels of allergens like pollen and dust. There is an increase in the number of cases reported during spring, alluding to a seasonal allergens. Hence the name “Seasonal Keratoconjunctivitis”. Interestingly, the word vernal means spring. The occurrence of this condition is not limited to spring unlike what its nomenclature suggests.

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It is predominant in children and adolescents. Its predominance is higher in males than in females especially in tropical regions. This is however only seen in childhood through to adolescents. The difference between the number of males and females with the condition reduces as the age is increased. A study showed that the ratio of males to females with the condition over the age of 20 is 1:1

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Sign and Symptoms
Signs of vernal keratoconjunctivitis are mostly restricted to the conjunctiva and cornea. Typically, vernal keratoconjunctivitis presents with hyperaemia, photophobia, tearing and pruritus (an uncomfortable irritation that creates the urge to scratch). Diffuse conjunctival injection is also seen in some cases. Usually vernal keratoconjunctivitis patients suffer several episodes of active inflammation throughout the year. Pruritus may be mild or intense. It may be aggravated by wind, dust, heat or even bright light. Photophobia, pain and foreign body sensation are caused by the involvement of the cornea. Some of the changes that occur on the cornea include plaque formation, punctate epithelial keratitis, epithelial macro-erosions, shield ulcer and late corneal vascularization. Amblyopia has been in reported in some cases however due to corneal opacities as a result of complication of vernal keratoconjunctivitis.

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Treatment
In dealing with any condition generally, patients are more likely to be compliant when they are well informed. Educating patients and close relatives on the chronic, recurrent and ultimately resolving nature of vernal keratoconjunctivitis is a very important aspect of the management of the condition. There are a variety of drugs for the treatment or management of vernal keratoconjunctivitis. They include anti-histamines, mast cell stabilizers, dual acting agents, corticosteroids and immunomodulators. None of the treatments is enough to treat the condition. Their actions are palliative and do not resolve the underlying issue, therefore the inflammation recurs each time it is exposed to the allergen or when the therapy is discontinued. When drugs fail to give the desired results, surgical treatment may be sought.

What is @bettervision about?

@bettervision is is a project initiated by @nattybongo and friends to give back to the society the knowledge and skill acquired through the Optometric Studies in Kwame Nkrumah University of Science and Technology, Ghana.It is an outreach system where we visit the less privileged communities to offer free eye screening services and education to the people within the community

AIMS AND OBJECTIVES
To reduce or prevent vision loss through diseases such as glaucoma, cataract and refractive errors.

To enlighten the majority of the Ghanaian population about the importance of proper visual care.

To conscientize people on the need for regular eye checks

To get more people to have their wards screened within the Critical periods of a Child’s Vision Development; thus from ages 3 to till about 10 years.

To help the blind and people with low vision live a better life within the society through education of the general public to stop stigmatization.

To help in the fight of extreme poverty that puts the health of people at risk

Our greatest gratitude goes to @fundition @adollaraday @surfyogi @girlsfoundation @bleepcoin @ackza @indigoocean @nanzo-scoop @steemstem @demotruk @pennsif @steem-ambassador @kasho and @wafrica for helping to make the aims and objectives of @bettervision a reality.