Vernal keratoconjunctivitis (VKC) is associated with which specific corneal complication that distinguishes it from other allergic conjunctivitis and may threaten vision?

• A Band keratopathy in inferior cornea due to calcium phosphate deposition
• B Interstitial keratitis with ghost vessels in mid-stroma
• C Shield ulcer (vernal plaque) — sterile, oval anterior stromal ulcer in superior cornea due to eosinophil-derived toxic proteins ✓
• D Peripheral ulcerative keratitis at the limbus due to complement-mediated stromal melting

Explanation

VKC can cause a shield ulcer (also called vernal plaque) — a characteristic oval-shaped sterile corneal ulcer in the superior cornea, typically under the upper lid giant papillae. It results from mechanical trauma by giant papillae combined with the toxic effects of eosinophil major basic protein (MBP) and eosinophil cationic protein deposited on the epithelium. Mucus accumulates in the base forming a plaque. Management includes debridement, topical steroids, and supratarsal corticosteroid injection. This is a sight-threatening complication unique to VKC.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.