From the Guidelines
Vernal conjunctivitis should be treated with topical cyclosporine 0.05-2% eye drops, which has been shown to reduce signs and symptoms compared to placebo, and can be used to prevent seasonal recurrences 1. The treatment of vernal conjunctivitis involves a stepwise approach, with general measures including modifying the environment to minimize exposure to allergens or irritants, using cool compresses, and ocular lubricants.
- Topical and oral antihistamines and topical mast-cell stabilizers can be useful to maintain comfort.
- For acute exacerbations, topical corticosteroids are usually necessary to control severe symptoms and signs, but their use should be limited due to the risk of glaucoma and cataracts. Some key points to consider in the treatment of vernal conjunctivitis include:
- The use of cyclosporine, which has been shown to be effective in reducing signs and symptoms, and can be used to prevent seasonal recurrences 1.
- The importance of avoiding eye rubbing and known allergens to prevent exacerbations.
- The need for regular follow-up to monitor for corneal complications, especially in severe cases. In severe sight-threatening cases that are not responsive to topical therapy, supratarsal injection of corticosteroid can be considered 1. Overall, the goal of treatment is to control symptoms, prevent complications, and improve quality of life, while minimizing the risk of adverse effects from treatment.
From the FDA Drug Label
Cromolyn Sodium Ophthalmic Solution USP, 4% is indicated in the treatment of vernal keratoconjunctivitis, vernal conjunctivitis, and vernal keratitis.
- Vernal conjunctivitis is a condition that can be treated with cromolyn sodium.
- The indication for use of cromolyn sodium includes vernal conjunctivitis 2.
From the Research
Definition and Symptoms of Vernal Conjunctivitis
- Vernal conjunctivitis is a bilateral, seasonal, external ocular inflammatory disease of unknown cause 3
- Afflicted patients experience intense itching, tearing, photophobia, and mucous discharge, and usually demonstrate large cobblestone papillae on their superior tarsal conjunctiva and limbal conjunctiva 3
- It primarily affects children, may be related to atopy, and has environmental and racial predilections 3
Treatment Options for Vernal Conjunctivitis
- First-line therapy of vernal conjunctivitis involves mast cell stabilizers and, if necessary, corticosteroid eye drops 4
- Nedocromil sodium 2% eye drops is significantly more effective than sodium cromoglycate for treatment of vernal keratoconjunctivitis (VKC) 5
- Topical bromfenac sodium can be used as baseline local treatment in patients with VKC, in combination with corticosteroids and anti-allergic eye drops 6
- Treatment of chronic forms of ocular allergies may necessitate collaborative efforts between the ophthalmologist and the allergist or immunologist 3