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The authors aimed to determine the knowledge, attitude, and practice among caregivers of children with vernal keratoconjunctivitis (VKC) to assess their level of understanding of the disease and factors that affect compliance with medical advice and compel them to use over-the-counter medicines. This was a cross-sectional study undertaken in 2018-19 in a tertiary care paediatric hospital in northern India. The study included caregivers of children <14 years with >two episodes of VKC in one year. Questions included an abbreviated version of the QUICK questionnaire. Two hundred and sixty-eight children had VKC in the period of this study: 65 met the inclusion criteria with 53 males and 12 females. Mean age was 6.4 ±1.2 years. Caregivers included 61 parents and four relatives. Average number of annual ophthalmology visits was three with a minimum of two episodes. Forty-five caregivers were unaware of the symptoms of the disease in the form of relieving and aggravating factors, seasonal variation, side-effects of eye drops and consequences of no treatment. About half of these were from lower middle-class families. Thirty were aware that delayed treatment could result in visual consequences if not treated. Nine had tried home remedies before seeking medical assessment. Most (81.53%) consulted ophthalmologists as the primary treatment provider. Most (86.15%) complied with follow-up and with treatment. This reduced significantly with increasing episodes of VKC and prolonged duration of symptoms. Eighty-three percent were unaware of side-effects of eye drops used. One quarter considered VKC affected school and other activities. The chronic course of disease was responsible for non-compliance with treatment in one-third. There was a significant association with appointment compliance due to financial constraints. Therefore, caregivers often used home remedies or over-the-counter medicines. Difficulty instilling drops also led to poor treatment compliance. There was a significant association with knowledge and compliance: those with good knowledge had better appointment compliance. Limitations of this study were its cross-sectional design and small sample size. The authors conclude that proper education of caregivers can affect compliance with treatment. A chronic course of the disease also impacts on compliance.

Knowledge, attitude and practice among caregivers of children with vernal keratoconjunctivitis in a tertiary care pediatric hospital.
Wadhwani M, Kursange S, Chopra K, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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