Association of Vernal Keratoconjunctivitis (VKC) with Keratoconus in Patients Presenting to Ophthalmology Clinics of Rawal Institute of Health Sciences, Pakistan

Article Information

Title: Association of Vernal Keratoconjunctivitis (VKC) with Keratoconus in Patients Presenting to Ophthalmology Clinics of Rawal Institute of Health Sciences, Pakistan

Authors: Maham Zehra, Mohd Shakaib Anwar, Erum Yousafzai, Qura-Tul- Ain, Waseem Akhter, Afia Matloob Rana

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2024

Volume: 74

Issue: 2

Language: English

Keywords: KeratoconusVernal Keratoconjunctivitisdiopters

Abstract

Objective: To establish an association of vernal keratoconjunctivitis with keratoconus.
Study Design: cross-sectional study.
Place and Duration of Study: Department of Ophthalmology, Rawal Institute of Health Sciences, Rawalpindi Pakistanv from Dec 2019 to Feb 2020.
Methodology: Patients with an age less than 16 years and a history of VKC were included. Ulcers or scars, systemic connective tissues, and blue sclera were excluded. Follow-up after two weeks and later three months was conducted. Individuals with K readings of less than 45 diopters were considered normal.
Results: Among the 135 individuals enrolled in the study, more males 95(70%) than women 40(30%) were observed. The study also showed more individuals from age groups 1-10 years of age 107(79%). After three months, biomicroscopic findings and corneal topography (Oculus Pentacam HR) revealed that 20 individuals (14.8%) developed keratoconus (p˂0.001). The disease severity, periodicity, and eye rubbing lead to the development of keratoconus.
Conclusion: Pediatric keratoconus deteriorates faster than adults, and the management differs for various reasons, such as faster progression and advanced stage of disease at the time of diagnosis. It burdens society as it influences children's quality of life and development. Hence, predisposing conditions such as Vernal keratoconjunctivitis need early diagnosis, recognition of progression, and appropriate intervention to prevent vision-threatening conditions such as keratoconus.

Disclaimer: The following sections are produced through an intensive multi-stage analytical pipeline developed by DefinePK, utilizing advanced natural-language processing, domain-specific knowledge models, and automated cross-referencing systems. Despite the rigor and computational effort involved, the generated summary may still contain inaccuracies or incomplete interpretations. Users are strongly advised to verify all critical information against the original paper and its authoritative sources.

Research Objective

To establish an association of vernal keratoconjunctivitis (VKC) with keratoconus.

Methodology

Cross-sectional study conducted at the Department of Ophthalmology, Rawal Institute of Health Sciences, Rawalpindi Pakistan from December 2019 to February 2020. Included patients under 16 with a history of VKC, excluding those with ulcers, scars, systemic connective tissues, or blue sclera. Follow-up was conducted after two weeks and three months. Data was analyzed using SPSS version 23 and MS Excel 2016.

Methodology Flowchart

                        graph TD
    A[Patient Enrollment VKC History] --> B[Exclusion Criteria Met?];
    B -- Yes --> C[Exclude Patient];
    B -- No --> D[Ophthalmic Examination];
    D --> E[K Readings > 45 Diopters?];
    E -- Yes --> F[Corneal Topography Oculus Pentacam HR];
    E -- No --> G[Normal Vision];
    F --> H[Keratoconus Diagnosis?];
    H -- Yes --> I[Keratoconus Confirmed];
    H -- No --> J[No Keratoconus];
    I --> K[Data Analysis SPSS, MS Excel];
    J --> K;
    G --> K;
    K --> L[Statistical Significancep<0.05?];
    L -- Yes --> M[Significant Association];
    L -- No --> N[No Significant Association];
    M --> O[Conclusion: VKC Associated with Keratoconus];
    N --> O[Conclusion: No Association];

Discussion

The study found an association between VKC and keratoconus, with approximately 15% of patients with severe VKC developing keratoconus. The severity of VKC symptoms was linked to the development of keratoconus. Eye rubbing and frequent glass changes were also associated with keratoconus.

Key Findings

Among 135 patients, 20 (14.8%) developed keratoconus after three months (p<0.001). Males were more affected (70%) than females (30%). Disease severity, periodicity, and eye rubbing were associated with keratoconus development.

Conclusion

VKC affects males more than females, and the progression to keratoconus depends on the age of VKC onset. Early diagnosis, recognition of risk factors, and regular monitoring of VKC are recommended to prevent vision-threatening complications like keratoconus.

Fact Check

1. Study period: December 2019 to February 2020 - Confirmed in Methodology section.
2. Sample size: 135 patients - Confirmed in Results section.
3. Keratoconus development: 14.8% - Confirmed in Results section.

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