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Purpose of review <p>Vernal keratoconjunctivitis (VKC) is a chronic disorder which predominantly affects children and young adults and is associated with risk of sight-threatening complications. The disease has a spectrum of presentations and several treatment options. This review aims to present the modalities in a stepwise manner corresponding to disease severity. The burden of disease and its significant impact on the quality of life make it important for clinicians to understand the evolving treatment paradigms for VKC.</p> Recent findings <p>Management aims to achieve sustained suppression of inflammation while minimizing corticosteroid exposure. A stepwise therapeutic strategy includes allergen avoidance, dual-acting antihistamine-mast cell stabilizers, short-duration corticosteroid pulses for acute exacerbations, and long-term steroid-sparing maintenance with topical calcineurin inhibitors. Refractory disease may necessitate systemic immunosuppression or biologic agents, particularly in patients with concomitant systemic atopy, in coordination with allergy specialists. Early detection and timely management of complications, such as shield ulcers and limbal stem cell deficiency, are essential for preserving visual function. </p> Summary <p>An algorithm-based, multidisciplinary approach provides a standardized framework for optimizing therapeutic outcomes, reducing disease morbidity, and maintaining long-term ocular surface stability in patients with VKC.</p>

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Vernal Keratoconjunctivitis: Toward a Structured, Algorithm-Based Management Strategy

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Nikhil S. Gokhale,
  • Anahita Kate,
  • Jayesh Vazirani,
  • Sayan Basu

摘要

Purpose of review

Vernal keratoconjunctivitis (VKC) is a chronic disorder which predominantly affects children and young adults and is associated with risk of sight-threatening complications. The disease has a spectrum of presentations and several treatment options. This review aims to present the modalities in a stepwise manner corresponding to disease severity. The burden of disease and its significant impact on the quality of life make it important for clinicians to understand the evolving treatment paradigms for VKC.

Recent findings

Management aims to achieve sustained suppression of inflammation while minimizing corticosteroid exposure. A stepwise therapeutic strategy includes allergen avoidance, dual-acting antihistamine-mast cell stabilizers, short-duration corticosteroid pulses for acute exacerbations, and long-term steroid-sparing maintenance with topical calcineurin inhibitors. Refractory disease may necessitate systemic immunosuppression or biologic agents, particularly in patients with concomitant systemic atopy, in coordination with allergy specialists. Early detection and timely management of complications, such as shield ulcers and limbal stem cell deficiency, are essential for preserving visual function.

Summary

An algorithm-based, multidisciplinary approach provides a standardized framework for optimizing therapeutic outcomes, reducing disease morbidity, and maintaining long-term ocular surface stability in patients with VKC.