Combined therapy for vernal shield ulcer

Kumar, Sunil

doi:10.1111/j.1444-0938.2007.00183.x

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…Off-label use of commercial preparation of cyclosporine (0.05%) eyedrops, recommended for the treatment of dry eye, decreased the symptoms and signs of VKC [40]. Topical corticosteroids and artificial tears have been shown to act synergistically with cyclosporine (0.05%) eyedrops and help in the re-epithelialization of corticosteroidresistant vernal shield ulcers [41]. Whether this commercially available formulation of cyclosporine is effective in the treatment of VKC needs to be tested in controlled trials.…”

Section: Immunomodulatorsmentioning

confidence: 98%

Modern Approach to Managing Vernal Keratoconjunctivitis

Kumar

Gupta

Vivian

2010

Curr Allergy Asthma Rep

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Vernal keratoconjunctivitis (VKC), an allergic inflammation of the conjunctiva affecting mainly children and adolescents, is categorized under the rubric of allergic conjunctivitis. Lack of uniform diagnostic and predefined staging criteria has been a bottleneck in formulating fixed guidelines to treat VKC. This lack of consensus among clinicians/researchers regarding diagnostic and grading standards has prevented us from making comparisons between the outcomes of different studies. To treat VKC, selection of a drug from many available options should be based on the duration and frequency of symptoms, grade and inflammation of giant papillae, and severity of corneal involvement. Consideration also should be given to the patient's specific needs. The basic tenet of treatment is optimal control of symptoms with a minimum of toxic side effects resulting from prolonged use of medication.

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Section: Immunomodulatorsmentioning

confidence: 98%

Modern Approach to Managing Vernal Keratoconjunctivitis

Kumar

Gupta

Vivian

2010

Curr Allergy Asthma Rep

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“…Off-label use of commercial preparation of cyclosporine (0.05%) eyedrops, recommended for the treatment of dry eye, decreased the symptoms and signs of VKC (Ozcan et al 2007). Topical corticosteroids and artificial tears have been shown to act synergistically with cyclosporine 0.05% eyedrops and help in the re-epithelialization of corticosteroid-resistant vernal shield ulcers (Kumar 2008). Whether this commercially available formulation of cyclosporine is effective in the treatment of VKC needs to be tested in controlled trials.…”

Section: Immunomodulatorsmentioning

confidence: 99%

Vernal keratoconjunctivitis: a major review

Kumar

2009

Acta Ophthalmologica

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191

216

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ABSTRACT.Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, at times asymmetrical, seasonally exacerbated, allergic inflammation of the ocular surface, involving tarsal and ⁄ or bulbar conjunctiva. Though the allergic nature of this entity has been accepted for a long time, the accumulation of a large amount of immunological data has proved that the pathogenesis of VKC is much more complex than a mere type 1 hypersensitivity reaction. In the past several years, many clinical and experimental studies about the cells and mediators involved in initiating and perpetuating the ocular allergic inflammation have shown that T helper type 2 cells and their cytokines, corneal fibroblasts and epithelium along with various growth factors play an important role in the pathogenesis of VKC. Based on this information about the pathogenesis of VKC newer, more selective drugs like anti-chemokine receptor antibodies and leukotriene receptor antagonists are under evaluation. Cyclosporine has been shown to be effective in the treatment of VKC but further randomized control trials are required to establish the minimum effective concentration.

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“…Our case also was unusual with two shield ulcers one of which located inferiorly. Shield ulcer usually responds to topical steroids, antihistamine eye drops and mast cell stabilizers [8,9]. Often steroids are given for short a period (4-6 weeks) with tapering regimen.…”

Section: Discussionmentioning

confidence: 99%

Vernal Keratoconjunctivitis with Atypical Localization of Shield Ulcer

Hovakimyan¹,

Kambulyan

Davtyan

et al. 2020

JAMMR

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Aims: To present an atypical case of vernal keratoconjunctivitis associated with unusual inferior location of shield ulcer. Presentation of Case: We are presenting an unusual case of vernal disease in a 7-year-old male associated with 2 corneal ulcers in the same eye, one of which was located inferiorly. The patient was prescribed topical steroids, antihistamine and lubricating eye drops. Three weeks later the symptoms got resolved and ulcers were healed, leaving mild subepithelial fibrosis. The patient was advised to continue antihistamine eye drops for the whole year with prophylactic dosage regimen. Discussion: Vernal keratoconjunctivitis is a bilateral, seasonally recurring inflammation of conjunctiva and cornea. It affects mostly children with male preponderance. In several cases vernal disease can be complicated with development of a shield ulcer, which usually has superior location under upper eyelid. Despite the fact that literature review has revealed two atypical cases with inferior localization reported in India, it is a very rare finding. Our case also was unusual with two shield ulcers, one of which was located inferiorly. Conclusion: This case demonstrates a very rare presentation of an atypical inferiorly located shield ulcer. Literature review revealed only two similar cases in India. Our case demonstrates the usage of topical steroids to be successful and advisable in the treatment of shield ulcer, as it controls the inflammation. Topical antihistamine medications should be added and given for a long period for preventing possible recurrences.

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Combined therapy for vernal shield ulcer

Cited by 10 publications

References 14 publications

Modern Approach to Managing Vernal Keratoconjunctivitis

Modern Approach to Managing Vernal Keratoconjunctivitis

Vernal keratoconjunctivitis: a major review

Vernal Keratoconjunctivitis with Atypical Localization of Shield Ulcer

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