Barriers to diagnosis and management of VKC

4 February 2025 | Fiona Rowe (Prof) | EYE - Paediatrics, EYE - Strabismus

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The authors investigate the lived experience of vernal keratoconjunctivitis (VKC) diagnosis and treatment in US patients, reported by their carers and eyecare clinicians, and to identify barriers to the timely diagnosis and management of this condition. The study included seven carers of seven boys (mean age seven years), and 16 clinicians (four general ophthalmology, four corneal, three paediatric, two ocular immunology, one allergist / immunologist, one neuro-ophthalmology and one optometry). Clinicians reported seeing an average of 77 cases annually. Responses from clinicians relating to presentation were that carers underestimated the severity of symptoms and attempted treatment with over-the-counter medications. Children generally did not complain of symptoms until advanced and severe symptoms developed. The first point of contact was usually primary care and therefore were often not diagnosed quickly because of misdiagnosis. Issues relating to treatment included a lack of VKC-specific guidelines and concerns regarding long-term treatment effects and adverse events. Regarding adherence, difficulties arise for long-term treatment maintenance, particularly as acute symptoms have settled. The authors conclude that limited awareness of VKC remains the main barrier to diagnosis and management.