Clinical and epidemiological profiles of vernal keratoconjunctivitis in a tertiary care setting: Association of disease pattern with recurrent attacks.

BACKGROUND

Vernal keratoconjunctivitis (VKC) is a chronic allergic disorder of the ocular surface that predominantly affects children in tropical and subtropical regions. Understanding how different anatomical disease patterns relate to recurrence is important for guiding effective management. This study aimed to evaluate the clinical profiles of VKC patients and assess the association between disease pattern and recurrence of attacks.

METHODS

This cross-sectional observational study included 132 VKC patients presenting to a tertiary care ophthalmology center. Patients were classified into limbal, palpebral, or mixed patterns based on anatomical involvement. Demographic data, clinical features, and attack patterns (initial versus recurrent) were recorded. Chi-square tests assessed associations between disease pattern and clinical variables.

RESULTS

The cohort comprised 85 males (64.39%) and 47 females (35.61%), with 72.73% aged ≤10 years. Itching (81.82%) and redness (66.67%) were predominant symptoms. Limbal VKC was most common (59.09%), followed by mixed (24.24%) and palpebral (16.67%) patterns. The overall recurrence rate was 78.79%, with the mixed pattern showing highest recurrence (93.75%) and palpebral the lowest (54.55%). The disease pattern showed highly significant association with type of attack (χ² = 12.05, P = 0.002). Palpebral VKC presented more commonly as initial attacks (35.71%), while the mixed pattern was strongly associated with recurrence (28.85% in recurrent vs 7.14% in initial attacks).

CONCLUSION

VKC demonstrates distinct clinical phenotypes with significant association between disease pattern and chronicity. Mixed VKC represents the most severe, recurrent form requiring aggressive long-term management.