The aim of this study was to develop best practice principles for diagnosis and management of vernal keratoconjunctivitis (VKC) in the UK. The authors convened a multidisciplinary panel of three paediatric ophthalmologists, two corneal specialists, a paediatric allergist and orthoptists. Each completed a questionnaire about management. A round table was then conducted to discuss symptoms and diagnosis, severity, referrals, initial treatment, long-term management and supportive care. They developed best practices to generate a standardised approach to treatment and care. Recommendations include appropriate and timely referral based on severity, joint management and importance of emotional support and outreach to schools.