Diagnosis? concentrate on the limbal area. Juvenile arcus or spring catarrh?

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This is limbal form of VKC There are mucoid deposit on limbus.... usually Tranta dots are also seen but not clear in this photo look for palpebral form of VKC also which is in form of papillae on superior tarsus Treatment Avoid allergan avoid rubbing eyes cold compresses use antiallergic eyedrop like olopatadine use lubricating eyedrop like flogel use mild steroid in pulse dose in severe case use cyclosporine or tacrolimus in chronic cases or steroid resistant cases

This is definitely spring catarrh. findings 1. the eyes look muddy 2. gelatinous elevated lesions at the limbus suggestive of limbal follicles 3. when these follicles will heal they will form pseudogerontoxon(false arcus) 4. look for papillae on everting the lid treatment will include mild steroids with topical lubricants and decongestants

limbal form of VKC(spring catarrh)...ask the pt about itching and dischaege (thick and ropy)... Arcus always has clear space between it and the limbus, which is not present in this case. so it is definitely not Arcus juvenilis

SPRING CATARRH

Spring catarrh

Spring catarrh, better to avoid steroids. Give olopatadine/cold compresses for itching, cyclosporine inj drops (0.45%), and avoid rubbing eyes.

Bulbar spring catarrah with limbal nodules collection of lymphocytes, eosinophils, epethelial cells and fibroblast

IT IS A CASE OF V K C WITH IMMEDIATE CORNEAL DYSTROPHY MIMICKING TRUE ARCUS SENALES

This is typically limbal type of vernal keratoconjunctivitis

vernal keratoconjunctivitis....

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