Long has suffered from vernal keratoconjunctivitis since he was 7 years old, with frequent recurrences. Recently, his eyes became swollen and painful, making it impossible for him to open them. Specialist doctor level II Le Thi Thanh Hai, from the High-Tech Eye Center at Tam Anh General Hospital Ho Chi Minh City, explained that vernal keratoconjunctivitis is a chronic condition that typically worsens in spring and summer due to seasonal allergens. The disease causes severe itching, redness, irritation, watery eyes, eyelid swelling, light sensitivity, and clear discharge. Difficulty opening the eyes can indicate the disease has affected the cornea, leading to reflex blepharospasm.

Doctors administered anesthetic eye drops to observe the boy's eye structures. An examination using slit-lamp biomicroscopy and optical coherence tomography (OCT) revealed conjunctival hyperemia, conjunctival edema, large cobblestone papillae on the palpebral conjunctiva, and bilateral corneal epithelial erosion. Long's vision was 7/10 in both eyes. Doctors diagnosed a corneal ulcer due to superinfected keratoconjunctivitis.

Long's condition, characterized by recurrent and prolonged conjunctivitis, had spread to his cornea, causing inflammation, ulceration, and corneal scarring. If not detected and treated promptly, the disease can lead to permanent vision impairment, or even blindness, according to Doctor Hai.

Doctor Hai turned off the lights and used blue light to examine Long's corneal surface. *Photo: Tam Anh General Hospital*

The patient received treatment with corticosteroid anti-inflammatory drugs combined with immunosuppressants to control the inflammation in his eyes. Once his condition stabilized, doctors discontinued the corticosteroids and maintained the immunosuppressants to limit the risk of recurrence.

A subsequent examination at the Clinical Immunology department confirmed that the boy was allergic to house dust mites. Doctors prescribed desensitization treatment for the allergens. At a follow-up one month later, Long's keratoconjunctivitis was controlled, and his vision reached 10/10 in each eye. His symptoms of itching, irritation, and eyelid swelling decreased, his corneal epithelium healed, and he could open and close his eyes normally.

Doctors note that vernal keratoconjunctivitis can recur. Patients need to attend follow-up appointments, limit exposure to house dust, pollen, pet dander, and smoke, and avoid rubbing their eyes when itchy. Children with an allergic constitution should maintain eye hygiene, wash their hands frequently, and wear glasses outdoors to limit exposure to allergens.

The disease is common in males, typically starting around age 5 and tending to decrease by puberty. If left untreated, it can cause corneal ulceration, corneal scarring, astigmatism, cataracts, and glaucoma. Individuals with a family history of allergic diseases, or a personal history of allergic rhinitis, asthma, or eczema, have a higher risk. When experiencing prolonged itching, redness, eye pain, or blurred vision, patients should seek medical attention, avoiding self-administering eye drops, as the condition may worsen or lead to complications.

Ngoc Kim Tham

*Patient's name has been changed