A Randomized Controlled Study of Antihistamines, Cyclosporine and Tacrolimus in Vernal Keratoconjunctivitis in Tertiary Eye Care Centre, Hyderabad

Background: Ocular allergies can affect various parts of the ocular surface, including the eyelids, lid margins, conjunctiva, and lacrimal system. The condition can range from mild to severe, potentially impacting quality of life and visual function. This study was done to determine the efficacy of Antihistamines Cyclosporine and Tacrolimus in Vernal Keratoconjunctivitis in the Tertiary Eye Care Centre. Methods: This cross-sectional study was done in the Department of Ophthalmology, Sarojini Devi Eye Hospital, Hyderabad. After receiving informed consent from the participants, or from their parents or legal guardians, patients with Vernal Kerato-conjunctivitis who were visiting our hospital’s ophthalmology outpatient department were evaluated for inclusion and exclusion criteria and included in the study. Each patient underwent a thorough ocular examination. Vernal keratoconjunctivitis symptoms and signs were assessed. Results: 60 patients were divided equally into three groups with 20 cases each. Significant improvement in redness was observed after 7 days of treatment in all groups. Cyclosporine showed the most significant reduction in symptoms, including itching, discharge, and photophobia, across follow-ups, with p-values less than 0.05. Olopatadine and tacrolimus also improved itching, redness, and photophobia, though cyclosporine was superior for discharge reduction. Tacrolimus was less effective in controlling discharge but effective for H.T.S and PGTn. Cyclosporine showed consistent improvement in all signs, making it the most effective treatment. Conclusion: Within the limitations of the current study, we found Olopatadine 0.1% eye drops had faster onset of action observable at 1 week. The maximum effect was seen by the end of 4 weeks, after this the effect seem to plateau off. Cyclosporine 0.05%, Tacrolimus 0.03% eye ointment had a maximum effect by the end of 3 months. The analysis of total showed that olopatadine has a faster onset of action demonstrated by lower scores in the first 2 weeks, later three drugs olopatadine, cyclosporine and tacrolimus had a similar efficacy.