A 12 years old boy presented in our OPD complaints of itching and redness in right eye since 2 months. There was associated history of copious mucous discharge in both eyes. On slit-lamp bio microscopic examination, right eye revealed two giant cobblestone papillae along with multiple small papillae while in the left eye small papillae were present. Right eye also showed Punctuate epithelial keratitis with no signs of corneal involvement in left eye. There was no history of use of contact lenses of suturing to the eye, hence, deviating from the diagnosis of giant papillary conjunctivitis. He was treated with oral and topical anti allergic medications. Cobblestone papillae persisted even after maximal tolerated dose. Two doses of Supratarsal injection of 20 mg Triamcenolone Acetonide (Corticosteroid) were given in right eye one month apart. We observed complete recovery from allergic symptoms. Cobblestone papillae and punctuate epithelial erosions regressed completely. Patient was asymptomatic after two months, i.e. no recurrence. In this case, we indicate the use of Supratarsal corticosteroid injection in recalcitrant vernal kerato-conjunctivitis. Promising results were seen without adjuvant topical or oral medications.
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