Cobblestone appearance is seen in:

Ans: c (Vernal conjunctivitis) Ref: AK Khurana, 4th ed, p. 74Cobblestone( pavement stone)--typical arrangement of hard flat topped papillae in palpebral conjunctivaVernal keratoconjunctivitisPhlyctenular conjunctivitis* Exogenous allergen(dust, pollen)* Type I HS* Bilateral* Endogenous microbial proteins(TB, staph)* Type IV HS(Delayed HS)* unilateral* C/F:itching, lacrimation, photophobia, ropy discharge (Maxwell lyon sign)* C/F; irritation, reflex lacrimation, discomfort(itching not marked)Conjunctival signsPalpebralCobblestone appearanceFollicles are not seenBulbar signsGelatinous limbusHomer tranta spotsDusky red triangular congestion Conjunctival signsPhlycten/nodule at limbus-characteristicConsists of subepithelial mononuclear infiltration in a triangular area with apex towards deeper margin* Nodules ulcerate at apex.Corneal signsEpithelial erosionSubepithelial punctate erosionPseudogerantoxon with classic cupid bow outlineCorneal signsFascicular ulcerMiliary ulcer(ring ulcer)Scrofulous ulcerUlcer may present. Rx : steroid dropsRx: steroid drops