Giant conjunctival papillae

This is vernal keratoconjunctivitis, a chronic, bilateral, and often seasonal allergic inflammation of the conjunctiva characterised by papillae on the inner eyelid and throughout the limbus (fig 1).1 The patient, an 11 year old boy, presented with a three month history of itching, irritation, and mucoid discharge from both eyes. His best corrected visual acuity was 6/6 in each eye. Slit lamp examination showed conjunctival congestion alongside large, flat topped, confluent cobblestone papillae across the upper and lower tarsal conjunctiva of both eyes. Notably, a congested papilla extended beyond the right eyelid on the lower tarsal conjunctiva.bmj;386/sep05_10/e078870/F1F1f1Fig 1Risk factors for this condition include male sex, exposure to dust, residing in a warm and dry climate, and a history of non-ocular allergic diseases. Vernal keratoconjunctivitis can be managed using topical antihistamines, mast cell stabilisers, immunomodulators, and corticosteroids.2 In instances where giant papillae do not respond adequately to medical treatment, surgical intervention…
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