A 10 year old boy presented to the ophthalmology opd with the chief complaints of itching, photophobia, burning, and watering eyes. On examination, dusky red triangular congestion of bulbar conjunctiva in palpebral area, gelatinous deposits around limbus and presence of discrete whitish raised dots along the limbus are seen. 1.what's the provisional diagnosis 2. How will you manage this case

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Diagnosis: VKC (Vernal keratoconjunctivitis) Bulbar type. Rx : 1. Low dose steroid eye drop ( FLI/FML) ..1 drop 4 times for 7 days ___> 1 drop 3 times for 7 days___>1 drop 2 times for 7 days ___> 1 drop once for 7 days. 2. Topical antihistaminis (olopatadine/betoact) 1 drop 2 times daily. 3. Lubricating eye drop ( Refresh tear/ Lubrex) 1 drop 3 times 4. Avoid dust. 5. Wear dark goggles. 6. Review after 2 weeks. If not improving; Cyclosporine or Azathioprine eyedrop.

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V K C BULBAR TYPE TREAMENT 1 OLOPAPATADINE EYE DROPS 2 NON STERIODAL ANTI INFLAMMATORY EYE DROPS 3 F M L EYE DROPS 4 MAST CELL INHIBITIRS EYE DROPS 5 ARTIFICIAL TEARS EYE DROPS 6 CYCLOSPORINE EYE DROPS 7 ANTIALLERGIC EYE DROPS 8 OLD EYE COMPRESSES

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Bulbar type of VKC Start treatment with low dose steroid and olopatidine .Stop using steroid drops after about 2 wks and continue with olopatidine drops .

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It's vernal kerato conjunctivitis.. Treatment- by tropical antihistamine and steroids

Allergic conjunctival olopetadine e/d and lubricating drops dark glasses .

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It's bulbar form of Vernal keratoconjunctivitis

Spring catarrh ,vernal keratoconjunctivitis

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vernal keratoconjunctivitis of bulbar type

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Phlyctenular kerato conjunctivitis

Bulbar vernal conjunctivitis.

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