Vernal Conjunctivitis - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Vernal conjunctivitis, or spring catarrh, is a type of allergic conjunctivitis that causes an infection of the eyes. The condition can cause redness, discomfort, and irritation in the eye tissues. Vernal conjunctivitis mainly occurs due to some allergic reactions caused by bacteria or viruses. Vernal conjunctivitis is more prevalent in the spring and summer due to seasonal increases in pollen (allergens) in the air. The infection can also occur due to various other allergic reactions, such as cigarette smoke, chlorine in swimming pools, or cosmetic products used by people. Vernal conjunctivitis is allergic conjunctivitis caused by an IgE-mediated (immunoglobulin E) hypersensitivity process or mechanism. The condition recurs seasonally and can cause severe allergic inflammation in the ocular surface and can cause severe damage to the eyes if not treated timely. But, since the recurrence rate of vernal conjunctivitis is high, it rarely causes vision loss.

What Are the Causes of Vernal Conjunctivitis?

Vernal conjunctivitis is caused by allergens such as pet dander or pollen and due to the presence of any past medical history of allergies such as allergic rhinitis, asthma, and eczema. Vernal conjunctivitis is also caused due to seasonal allergies occurring in a person. The condition is more prevalent in young males.

What Are the Various Types of Conjunctivitis?

The various types of conjunctivitis are

• Infectious Conjunctivitis- Bacterial, viral, protozoal, fungal, and parasitic.

• Allergic Conjunctivitis- Seasonal allergic conjunctivitis, giant papillary conjunctivitis, atopic keratoconjunctivitis, perennial allergic conjunctivitis, and vernal conjunctivitis

• Neonatal Conjunctivitis- Viral, bacterial, and chemical.

• Irritative or Chemical Conjunctivitis.

• Keratoconjunctivitis Sicca- This is also called dry eye syndrome.

• Superior Limbic Keratoconjunctivitis.

What Are the Symptoms of Vernal Conjunctivitis?

The symptoms of vernal conjunctivitis are as follows:

• Redness in the eyes.

• Blurry vision.

• Burning sensation in the eyes.

• Sensitivity to light.

• White mucus discharge from the eyes.

• Bumpy and rough eyelids.

• Painful, itchy, and irritated eyes.

• Swelling or inflammation around the eyes.

What Are the Risk Factors Causing Vernal Conjunctivitis?

The risk factors for vernal conjunctivitis are as follows:

• Pollen from grass and trees.

• Smoke.

• Perfume.

• Air pollution and dust.

• Seasonal (summer and spring) month.

• Animal secretions such as saliva and animal skin.

• Cosmetic products.

What Are the Predisposing Factors For Vernal Conjunctivitis?

• Season- Most common in summer seasons, also known as Warm weather conjunctivitis.

• Age- Vernal conjunctivitis is more prevalent in boys than in girls and usually occurs between the age of 4 to 20 years.

• Climate- The disease mainly occurs in the summer, hence called summer or spring catarrh, and can be seen more in tropical regions.

How Is Vernal Conjunctivitis Diagnosed?

Vernal conjunctivitis is diagnosed by performing an eye examination by the doctor, as there are no laboratory tests for diagnostic procedures to be established for this condition. Therefore, apart from a physical exam, the doctor can also ask about a person's current and past medical history and if they are allergic to any medication or cosmetic products. In addition, the doctor inquires about any known allergies causing these symptoms in a person.

How Is Vernal Conjunctivitis Treated?

The doctor can treat vernal conjunctivitis in the following ways:

• Cold compression of the eyes can be soothing during vernal conjunctivitis.

• In addition, the person can use lubricating drops to soothe the eyes.

• Treatment may also include anti-inflammatory or antihistamine eye drops placed in the eyes.

• Severe reactions are also treated with mild topical steroids directly applied to the eyes' surface for relief.

• The doctor also prescribes eye drops to prevent the histamines released in the eyes by mast cells, a type of white blood cell.

• Recently, the FDA (Food and Drug Administration, United States) has also approved the mild anti-cancer drug cyclosporin A 0.1 % as a treatment option for the acute condition of vernal conjunctivitis to prevent the recurrence of this disease.

What Is the Prognosis of Vernal Conjunctivitis?

The prognosis of vernal conjunctivitis is favorable as the allergic reactions grow away readily. The condition does not cause severe complications and rarely causes keratoconus or corneal ulcers in a person. The state also does not cause any damage to the eyes if treated timely, and vision loss as the condition can recur.

What Are the Complications Related To Vernal Conjunctivitis?

The complications of vernal conjunctivitis may include the following:

• Blurred or reduced vision.

• Microbial keratitis.

• Vernal plaques.

• Scarring of the cornea.

• Shield ulcers.

• Continuing discomfort.

• Keratoconus.

What Are the Differential Diagnosis for Vernal Conjunctivitis?

The differential diagnosis includes

• Seasonal allergic conjunctivitis.

• Atopic keratoconjunctivitis.

• Giant papillary conjunctivitis.

• Perennial allergic conjunctivitis.

• Chlamydial infections.

How Is Vernal Conjunctivitis Prevented?

Vernal conjunctivitis occurs for various reasons and can be prevented in the following ways:

• Seasonal changes due to seasonal allergens cause vernal conjunctivitis. These can be prevented by wearing a pollen mask outside the home or staying indoors when the pollen count is high. People should also keep doors and windows closed during pollen grain season.

• People should also avoid exposure to airborne allergens or irritants such as diesel exhaust, cigarette smoke, and perfumes. Vernal conjunctivitis can be prevented by simply avoiding exposure to irritants.

• Bacteria and viruses in the environment also cause infection of the eyes, leading to itchy eyes. This can also be minimized by frequently washing the eyes with cold water throughout the day.

• In addition, people should wear sunglasses and other protective equipment during pollen season to protect the eyes.

Conclusion

Vernal conjunctivitis is a common condition of the eyes that causes mucus discharge and redness in a person's vision. The disease can be caused by some allergens or an allergic sensitivity to someone's cosmetic products and chronic inflammation caused by an underlying condition. The actual cause of the disease is difficult to identify, but the symptoms can be managed with various treatment options. However, if vernal conjunctivitis is left untreated, it can cause vision defects or severe damage to a person's eyes. Therefore, a person with seasonal allergies or symptoms of vernal conjunctivitis should consult the doctor immediately and follow the necessary preventive measures.