New discoveries regarding the pathogenesis of ocular allergies have clearly indicated that the participation of the entire ocular surface in allergic diseases is not only the consequence of tissue contiguity but derives from a complex exchange of information between these tissues through cell to cell communications, chemical mediators, cytokines, and adhesion molecules. It is also possible that the neural and endocrine systems may influence the ocular allergic response.The purpose of this paper is to describe the clinical expression of VKC, to discuss its pathogenetic mechanisms, and to suggest novel therapeutic strategies.Top of pageClinical featuresVKC is a chronic bilateral inflammation of the conjunctiva characterized by hyperaemia, chemosis, photophobia, and filamentous and sticky mucous discharge. The hallmark of the disease is the presence of giant papillae (cobblestone appearance) at the upper tarsal conjunctiva (tarsal form) or at limbus (bulbar form).1,2,3 Although there are some differences between the two forms, probably related to geographical variations, it seems likely that both represent different clinical manifestations of the same disease.1 (Figures 1, 2 and 3).Full figure and legend (123K)VKC mainly affects boys in their first decade of life and the sequelae of the disease may be responsible for permanent visual impairment.
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