Frequency, types, and factors associated with Vernal Keratoconjunctivitis in children aged 1-12 years at a tertiary eye care hospital in Peshawar, Pakistan

Frequency, types, and factors associated with Vernal Keratoconjunctivitis in children aged 1-12 years

Abstract

Introduction: Vernal keratoconjunctivitis (VKC) is a chronic, recurrent allergic eye disease of childhood, particularly prevalent in warm and dry climates.

Objective: To determine the frequency, types, and factors associated with VKC in children aged 1-12 years attending a tertiary care eye outpatient department in Peshawar, Pakistan.

Methodology: This cross-sectional study enrolled 304 children from January 2021 to June 2022. Vernal keratoconjunctivitis (VKC) was diagnosed using Bonini’s clinical criteria based on characteristic symptoms and signs. Cases were classified into palpebral, limbal, or mixed subtypes. Data on demographics and potential risk factors were collected. Statistical associations were evaluated using the Chi-square test, with significance set at p ≤ 0.05.

Results: The frequency of vernal keratoconjunctivitis (VKC) was 13.2%. Palpebral VKC was the most common subtype (47.5%), followed by limbal (27.5%) and mixed (25%) types. VKC was more frequently observed in children aged 7–12 years compared to those aged 1–6 years (p<0.001). A significantly higher prevalence was noted among children from lower socioeconomic backgrounds (22.1% vs. 8.3% in middle and 6.4% in higher classes; p<0.001), those with malnutrition (25.4% vs. 10.1%; p<0.001), eczema (29.7% vs. 10.9%; p<0.001), and rhinitis (19.8% vs. 8.4%; p< 0.004). Dust/outdoor exposure (24% vs. 9.6%; p<0.001) and sunlight exposure exceeding six hours per day (28.4% vs. 8.9%; p<0.001) were also significantly associated with VKC.

Conclusion: This study highlights a significant frequency of VKC among children in Peshawar. The findings suggest a link between VKC and socioeconomic factors, allergies, and environmental exposures.