“This VKC blog is sponsored and supported by Santen Canada Inc.”
A rare allergic eye disorder affecting children and adolescents is often missed by parents and can cause lasting damage. VKC, vernal keratoconjunctivitis, usually strikes during main allergy seasons, but it can also be present all year round.
VKC is a relatively rare disorder. Public awareness is very low,” says Dr. Michael O’Connor, Pediatric Ophthalmologist at the Children’s Hospital of Eastern Ontario (CHEO in Ottawa), and Past-President of the Canadian Association of Paediatric Ophthalmology and Strabismus (CAPOS).
Common Symptoms of This Eye Disorder
With a range of symptoms that mimic allergies and pink eye, VKC can easily be overlooked, but there are a few reasons parents need to understand what this eye disorder looks like and what to do if you suspect your child or youth might have Vernal Keratoconjunctivitis.
Itching, burning, red, watery eyes and discharge. Any of these symptoms can lead parents and educators to assume the culprit is either pink eye or simple allergies. But here’s the thing: VKC, when it goes undiagnosed can cause scarring and pain. This childhood eye disorder can also lead to quality of life issues that might surprise you.
The prevalence of VKC is hard to pinpoint, says Dr. O’Connor. “So many cases go undiagnosed.”
This eye disorder mostly occurs in children. Why? Well, there’s a change in your immune system as you become an adult, which means you are less susceptible to VKC as an adult.
What Parents Need to Know
If what looks like pink eye or seasonal allergies with painful, itchy and watery eyes evolves into sensitivity to light, you might have something to be concerned about. The sensitivity to the light can mean that there are changes to the cornea – the transparent central surface of the eye.
Visible bumps may show up on the white part of the eye or underside of upper eyelid. Those bumps do not occur with allergies or conjunctivitis
Some people have symptoms that don’t follow the seasons.
How It Differs From Pink Eye
Pink eye can be viral conjunctivitis or bacterial conjunctivitis and while there might be some mild light sensitivity with this condition, it’s when it is prolonged sensitivity to light that suggests something else is going on. Bacterial pink eye should not involve the cornea. Even with pink eye kids should be able to open their eyes in normal light.
As is often the case with kids, sometimes these things sneak up slowly and chronically. Physical symptoms can result in behaviours that you simply start to think are part of a child’s personality.
“It tends to be normalized inside a family. Oh, that’s just Joey, he doesn’t really like to play outside,” says Dr. O’Connor.
Parents might think that their child is just not athletic or interested in going outside when in fact they are avoiding the outdoors and sports because they can’t stand bright light.
“Once we get children in treatment, we can often make a dramatic impact.”
Treatment depends on whether the case is mild, moderate, severe or very severe. Mild treatment can be as simple as cold compresses and over the counter lubricating drops. Staying indoors when pollen counts are high might also help with these milder cases. Drops, allergy pills, antihistamines, topical steroids and cyclosporine drops might be used depending on the severity of the case.
“Many of these things have generally all been tried before patients come to see me,” says O’Connor.
If scarring has not yet occurred, most patients do well with appropriate treatment. Severe and very severe cases are pretty rare.
The Age Group
Typically, school aged children are the ones you might see VKC in. It’s unusual to find this eye disorder in children under age 4.
Eyes are red. The white part of the eye is red. Discharge is ropey, the mucus can be wiped with a tissue. It is not contagious and there’s no specific genetic disposition to VKC.
These kids often miss a lot of school because it is confused with pink eye and schools send kids home if they think they have pink eye because of how contagious it is. Or they might be the child who is seated near the window in the classroom but can’t stand being near the window and nobody can figure out why. They need sunglasses a lot of the time.
They really are needing short term accommodation and then they can often function more or less normally, O’Connor says.
Another clue parents might not pick up on is avoidance behaviour. Maybe kids can’t tell you that the light is bothering them or that they have pain in their eyes. Instead, they avoid sports and playing outside.
Quality of Life
Quality of life is impacted when kids stop doing the things that they love, like playing soccer or basketball because the light outside or in the gym is too bright. They might stop swimming and they normally love the water.
What to Do If You Suspect VKC
If you suspect your child could have VKC, or unexplained eye pain, you should get a referral to a specialist. Start with your family doctor or an optometrist. Optometrists, who deal with eye health, can then refer to a paediatric ophthalmologist, if that step is necessary.
Like many health issues with kids, sometimes parents need to be detectives to understand what’s really going on. They can’t always tell you clearly where pain is or what’s happening. The good news is that early intervention and treatment VKC is manageable and can be caught before it causes too much pain or harm to the surface of the eye.