Associate Professor, Department of Ophthalmology, Sri Lakshmi Narayana Institute of Medical Sciences, Kudapakkam Post,Puducherry, 605502, India
Refractory Vernal Kerato conjunctivitis ,Supra-Tarsal Injections ,Corticosteroids ,

ABSTRACT In young patients who are susceptible to atopy, vernal keratoconjunctivitis (VKC) is a bilateral, recurrent interstitial inflammation of the conjunctiva that arises in warm weather. Eighty percent of the patients are under the age of fourteen. At a 2:1 ratio, boys are frequently more affected than girls. Severe itching, photophobia, redness, tearing, and persistent discharge are the main symptoms of this condition. Cobblestone papillae in the upper tarsal conjunctiva, limbal conjunctival thickening with gelatinous nodules, and Tranta's spots are all clinical indications of conjunctivitis. Shield ulcers and pannus are two types of corneal involvement. The condition usually goes away on its own between the ages of 2 and 10. The aim of this study is to investigate and assess the effectiveness of suprasternal injections of dexamethasone sodium phosphate, triamcinolone acetonide, and hydrocortisone sodium succinate in the treatment of refractory vernal keratoconjunctivitis (VKC). Supra-tarsal injection of corticosteroids provides immediate symptomatic relief by reducing inflammation locally. Intra-lesioned depot steroid injections do not raise significant blood cortisol levels to exert systemic anti-inflammatory activity or cause remission of inflammation at another site in the body. However, in our investigation, all patients' symptoms and indicators recurred over the follow-up period. Mild to moderate recurrence was found in 16 percent and 23 percent of patients, respectively. This could be due to climatic fluctuations in the patients' environment. Our patients were from arid and sandy regions, where the climate is a major risk factor for VK

5 , 3 , 2015