Phlectenular conjunctivitis is-

Ans. is 'd' i.e. Type IV reaction Phlyctenular keratoconjunctivitiso Phlyctenular conjunctivitis is an allergic response of the conjunctival and corneal epithelium to some endogenous allergens and characterized by formation of the phlyctens. Phlyctens are grey, yellow or pinkish white nodules slightly raised above the surface, are seen on the bulbar conjunctiva, generally near the limbus. Peak age group is 3-15 years with slight female preponderance.Etiologyo It is believed to be a delayed hypersensitivity (Type IV cell mediated) response to endogenous microbial proteins.Causative allergens are : - i) Staphylococcus proteins (most common); ii) Tuberculous proteins; iii) Proteins of Moraxella axenfeld bacillus and certain parasites.Symptomso Disease is usually unilateral (in contrast to vernal keratoconjunctivitis which is bilateral). There is mild irritation, discomfort and lacrimation. Itching is not prominent as seen in vernal keratoconjunctivitiso Phlyctens are pinkish white nodules at limbus. Phlyctens are surrounded by hyperamia (congestion) and this congestion of vessels is limited to the area around phlyctens. Phlyctens ulcerate at apexo Corneal involvement may result in miliary ulcer, ring ulcer, fascicular ulcer or sacrofulous ulcer. There may be diffuse infiltrative phlyctenular keratitis.Treatmento Topical steroids are the DOC.