Clinicians' Perspectives on the Management of Vernal Keratoconjunctivitis (VKC) in Indian Settings

Background: Vernal keratoconjunctivitis (VKC) is a chronic, bilateral allergic inflammation of the conjunctiva that tends to recur over time. Globally, VKC represents around 1% of all eye diseases, whereas in tropical areas, it contributes to approximately 3% of serious ophthalmic cases. Objective: The present study assesses clinicians' perspectives and preferences on the diagnosis, treatment approaches, and therapeutic strategies in the management of vernal keratoconjunctivitis (VKC) conducted in Indian settings. Methods: The cross-sectional study was conducted using a multi-response questionnaire among ophthalmologists specialized in managing vernal keratoconjunctivitis across India. The questionnaire included 23 items designed to assess clinicians’ views on VKC management strategies and treatment preferences. Data were analyzed using descriptive statistical methods, and visual representations were generated using Microsoft Excel 2013. Results: The study included 151 participants. Approximately 64% reported that VKC most commonly affects children. About 61% identified the mixed form of VKC as the most frequently observed clinical presentation. Olopatadine was cited as the preferred treatment for children by 60% of respondents and for patients with giant papillary conjunctivitis by 49%. Additionally, 56% of participants indicated that ketorolac is the most commonly used topical nonsteroidal anti-inflammatory drug (NSAID) for VKC. For diagnostic evaluation, around 70% preferred assessing both serum IgE levels and absolute eosinophil counts. Allergic rhinitis (AR) was the most frequently associated comorbidity, reported by 89% of clinicians. Nearly 79% of respondents rated trehalose as effective or very effective in managing VKC. Conclusion: The study findings suggest that VKC predominantly affects children, with the mixed form being the most common presentation. Olopatadine, topical steroids, ketorolac, and trehalose are widely preferred for treatment. These insights emphasize the need for standardized, evidence-based management strategies to ensure optimal patient outcomes.