A 22-year-old atopic patient presents with severe itching, photophobia, ropy mucus discharge, and cobblestone papillae on the upper tarsal conjunctiva, along with a Trantas dot at the limbus. This is most consistent with:

• A Acute bacterial conjunctivitis
• B Vernal keratoconjunctivitis (VKC) ✓
• C Giant papillary conjunctivitis from contact lens
• D Follicular conjunctivitis from Chlamydia

Explanation

Vernal keratoconjunctivitis (VKC) is a bilateral, recurrent, seasonally exacerbated allergic inflammation occurring predominantly in young atopic males in warm climates. Key features include intense itching, giant cobblestone papillae on the upper tarsal plate (palpebral VKC), gelatinous Horner-Trantas dots at the limbus (limbal VKC—aggregates of eosinophils and degenerated epithelial cells), and thick ropy mucus (from eosinophil major basic protein). A shield corneal ulcer (sterile, central, horizontal) is a sight-threatening complication. Treatment includes topical mast cell stabilisers, antihistamines, and short-course steroids for acute attacks.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.