A 12 year old boy presents with recurrent attacks of conjunctivitis during warm season for the last 2 years with intense itching and ropy discharge. Horner-Trantas dots are seen on the limbal region. The diagnosis is:
High-Yield Explanation
Vernal conjunctivitis characteristically affects children and adolescents; the incidence decreases sharply after the second decade of life. Vernal conjunctivitis occurs only in the warm months of the year. The disease characteristically produces giant ("cobblestone") papillae of the tarsal conjunctiva. The keratinized epithelium from these papillae may abrade the underlying cornea, giving rise to complaints of foreign body sensation or even producing frank epithelial loss ("shield ulcer"). This disease affects the limbal region, producing a characteristic gelatinous thickening of the limbal conjunctiva, often associated with white accumulations of eosinophils and desquamated epithelial cells ("Horner-Trantas dots"). Ref: Chan T.Y., Hodge W.G. (2011). Chapter 16. Immunologic Diseases of the Eye. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.