Atopic keratoconjunctivitis in children more common than believed

Allergy investigations key to making more accurate diagnosis

Priscilla Lynch

Posted: Sunday, September 15, 2019

Frederic Chiambaretta

ATOPIC keratoconjunctivitis (AKC) in children is more common than believed and requires a multidisciplinary approach for optimal outcomes, yesterday’s dedicated EuCornea session on ocular surface diseases in paediatric patients was told.

Frederic Chiambaretta MD, France, acknowledged that distinguishing between vernal keratoconjunctivitis (VKC) and AKC can be challenging. While VKC is mostly associated with adults, it may be more prevalent in children than initially believed, however. He quoted epidemiological data on 134 patients with allergic conjunctivitis, where 55% of patients with AKC reported an onset of symptoms before 10 years of age.

In Japanese populations, VKC cases with any history of atopic dermatitis are diagnosed as AKC, regardless of patient age, he added.

Allergy investigations are key to helping make a more accurate diagnosis of AKC in children, as is seeing if there is a history of eczema and conjunctivitis/keratitis, he said. Allergists and ophthalmologists need to work together to correctly diagnose these patients as AKC and VKC differ in relation to treatment needs; the dermatologic manifestations (eg, lid eczema) of AKC need specific treatment such as hydration, low-potency skin steroids and skin tacrolimus.

Ocular manifestations can also be more severe in AKC, specifically corneal complications, Dr Chiambaretta noted.