RARE DISEASE
Vernal keratoconjunctivitis
Vernal keratoconjunctivitis
Vernal keratoconjunctivitis
Synonyms: Spring catarrh
Synonyms: Spring catarrh
Synonyms: Spring catarrh
Drug discovery
10
drugs
With orphan designations
Overview
Vernal keratoconjunctivitis (VKC) is a chronic, IgE- and non-IgE-mediated allergic ocular disorder causing severe corneal and conjunctival inflammation, primarily affecting children in warm climates [1][5][6]. Symptoms include intense itching, photophobia, mucoid discharge, and cobblestone papillae on the eyelids, with potential corneal ulcers, scarring, and vision loss if untreated [1][6][14]. Chronic inflammation drives tissue remodeling and corneal complications, requiring aggressive management [5][6].
Therapies
First-line: Mast cell stabilizers (lodoxamide), dual-action antihistamines, and topical cyclosporine/tacrolimus for long-term immunomodulation [2][3][6].
Acute flares: Short pulses of low-absorption corticosteroids (loteprednol) [2][6].
Refractory cases: Biologics (omalizumab) or surgical plaque excision [2][5][14].
Categories: rare ophthalmic disorders
Research Papers
922 drug discovery papers about Vernal keratoconjunctivitis, with 1 first-in-class and 20 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
922 drug discovery papers about Vernal keratoconjunctivitis, with 1 first-in-class and 20 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
2026-08-04 | The Past, the Present, and the Future of Periostin in Allergy.
Periostin is a matricellular protein that binds to its receptors, which include several integrin molecules but mainly αvβ3 integrin on cell surfaces, thereby transducing its signals into cells. Almost 20 years have passed since we found that periostin is involved in the pathogenesis of asthma, which marked the first evidence of its involvement in allergic diseases. Over the past 2 decades, cumulative evidence has demonstrated that periostin plays important roles in the onset or progress of many allergic diseases such as chronic rhinitis with nasal polyp, atopic dermatitis (AD), allergic conjunctivitis, eosinophilic esophagitis, eosinophilic otitis media, allergic rhinitis, and eosinophilic granulomatosis with polyangiitis. Starting from the observation of highly expressed periostin in the lesions of these diseases, periostin studies have expanded to include how periostin contributes to the generation of allergic phenotypes, how measurement of periostin is useful as a biomarker for allergic diseases, and recently how periostin inhibitors can improve allergic diseases. Periostin contributes to the generation of allergic phenotypes by acting as a matricellular protein on many cells, including both non-immune and immune cells. Based on the characteristics of periostin as a surrogate biomarker of interleukin-13, a signature cytokine of type 2 inflammation, serum periostin has been used as a biomarker for stratifying endotypes, estimating disease severity, predicting or monitoring the efficacy of therapeutic drugs, and predicting disease relapse or recurrence. Moreover, a lot of attention is now being paid to periostin in body fluids such as tears and sputum as a biomarker directly reflecting type 2 inflammation. Since it has been shown that periostin evokes itch in AD, we hope to see the development of a novel therapeutic agent for AD targeting periostin/αvβ3 integrin. Here we summarize the discovery and characteristics of periostin, as well as questions and/or problems regarding periostin that remain to be resolved.
2026-08-03 | An interdisciplinary framework for management of ocular allergy: Integrating the allergist in clinical practice.
Ocular allergy represents one of the most frequent yet under-recognized manifestations of pediatric allergic disorders, affecting up to 30% of children worldwide. The disease encompasses a spectrum ranging from mild, intermittent seasonal or perennial allergic conjunctivitis to severe, vision-threatening forms such as vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). Despite its high prevalence and the strong association with systemic allergic diseases-including asthma, allergic rhinitis, and atopic dermatitis-the involvement of pediatric allergists in routine ocular allergy care remains limited. This review proposes an interdisciplinary framework that integrates allergists more centrally into ocular allergy management. A structured approach to diagnosis highlights the allergist's essential role in identifying systemic triggers, performing allergy testing, and differentiating ocular allergy from mimics such as viral conjunctivitis, blepharitis, and autoimmune ocular surface disease. Management, as a stepwise, collaborative strategy beginning with allergen avoidance and topical dual-acting antihistamine/mast-cell stabilizers, progressing to steroid-sparing immunomodulators, systemic therapy, and advanced options such as allergen immunotherapy, emerging biologic treatments, including omalizumab and dupilumab, is discussed in the context of severe VKC and AKC, along with benefits, limitations, and need for ophthalmic oversight. This framework underscores the importance of timely referral from ophthalmologists to pediatric allergists, co-management of complex cases, and early integration of systemic allergy care. Through interdisciplinary collaboration, long-term visual outcomes can be improved and inappropriate steroid use minimized. A practical interdisciplinary care pathway and treatment escalation algorithm are proposed to facilitate real-world collaborative management.
2026-07-01 | Efficacy of topical 0.05% cyclosporine in Vernal Keratoconjunctivitis in children aged 5-15 years visiting outpatient department
Purpose:To assess the effectiveness and safety of short-term use of topical 0.05% cyclosporine in children with Vernal Keratoconjunctivitis (VKC).Study Design: Quasi experimental study. Place and Duration of Study: Sheikh Zayed Medical College and Hospital in Rahim Yar Khan from April 2025 to September 2026. Methods: A Consecutive sampling was done to include 78 children of 5-15 years of age who had clinically identified VKC. The analysis involved one eye of each patient. They were treated with the topical cyclosporine 0.05% eye drops four times per day for one month. The severity of the disease was evaluated using a validated clinical scoring system that included symptoms and indicators at baseline and after one month. Treatment was considered effective if there was at least one point improvement in the total VKC score from baseline. Results: There were 65.4% males. The total VKC score dropped significantly from the baseline of 10.0 [IQR: 8.0-13.0] to 4.0 [IQR: 2.0-6.0] after one month (p <0.001). Clinical improvement was noted in 69 patients (88.5%). No substantial differences in treatment response were observed based on age, gender, duration of symptoms, or daily computer usage. A mild, temporary burning sensation was observed in 7% of individuals. Conclusion: Topical 0.05% cyclosporine provided substantial short-term therapeutic improvement and exhibited a positive safety profile in pediatric patients with VKC.Larger, randomized controlled trials with longer follow-up are needed to confirm these preliminary findings and to establish the long-term role of this treatment in VKC management.
2026-07-01 | Clinical Profile and Recurrence Patterns of Vernal Keratoconjunctivitis in a Tertiary Care Setting
Abstract Background: Vernal keratoconjunctivitis (VKC) is a chronic allergic condition of the ocular surface that primarily affects youngsters in the tropical and subtropical areas. Understanding how diverse anatomical disease patterns influence recurrence is critical for effective therapy. The purpose of this study was to investigate the clinical profile of VKC patients and determine the relationship between illness pattern and recurrence of episodes. Materials and Methods: This hospital-based, cross-sectional, and observational study included 132 VKC patients presenting to a tertiary care ophthalmology center. Patients were classified into limbal, palpebral, or mixed patterns based on anatomical involvement. Demographic data, clinical features, and episode patterns (initial vs. recurrent) were recorded. The Chi-square tests assessed the associations between disease pattern and clinical variables. Results: The cohort comprised 85 males (64.39%) and 47 females (35.61%), with 72.73% aged ≤10 years. Itching (81.82%) and redness (66.67%) were predominant symptoms. Limbal VKC was most common (59.09%), followed by mixed (24.24%) and palpebral (16.67%) patterns. Overall recurrence rate was 78.79%, with mixed pattern showing highest recurrence (93.75%) and palpebral the lowest (54.55%). Disease pattern showed highly significant association with the type of episode ( χ 2 = 12.05, P = 0.002). Palpebral VKC presented more commonly as initial episodes (35.71%), while mixed pattern was strongly associated with recurrence (28.85% in recurrent vs. 7.14% in initial episodes). Conclusion: VKC demonstrates distinct clinical phenotypes with significant association between disease pattern and chronicity. Mixed VKC was significantly associated with higher recurrence rates and greater symptom burden in this cohort. Disease pattern was significantly associated with recurrence and symptom burden in this cross-sectional sample.
2026-06-27 | A clinical study on patterns of vernal keratoconjunctivitis among children in rural part of North-East India
Objectives: The objective of the study is to evaluate the demographic profile, clinical patterns, and environmental risk factors of vernal keratoconjunctivitis (VKC) among children attending a tertiary care center in a rural region of North-East India. Material and Methods: This hospital-based descriptive cross-sectional study was conducted from February 2024 to January 2025. It included 100 children (aged 0–18 years) clinically diagnosed with VKC. Data regarding demographics, clinical signs, symptoms, and environmental exposures (including cooking fuel and animal contact) were collected using a structured pro forma. Results: The mean age of presentation was 12.02 years, with a significant male preponderance (male: female ratio 2.03:1). Symptom exacerbation peaked in May. The most common symptom was intense itching (91%), and the most common sign was conjunctival hyperemia (88%). The Limbal variant was the predominant phenotype (72%). A significant association was observed with the use of firewood/kerosene for indoor cooking. Conclusion: VKC in North-East India predominantly affects young males and presents chiefly as the Limbal form. Indoor air pollution from biomass fuels is a significant modifiable risk factor in this rural population.
2026-08-04 | The Past, the Present, and the Future of Periostin in Allergy.
Periostin is a matricellular protein that binds to its receptors, which include several integrin molecules but mainly αvβ3 integrin on cell surfaces, thereby transducing its signals into cells. Almost 20 years have passed since we found that periostin is involved in the pathogenesis of asthma, which marked the first evidence of its involvement in allergic diseases. Over the past 2 decades, cumulative evidence has demonstrated that periostin plays important roles in the onset or progress of many allergic diseases such as chronic rhinitis with nasal polyp, atopic dermatitis (AD), allergic conjunctivitis, eosinophilic esophagitis, eosinophilic otitis media, allergic rhinitis, and eosinophilic granulomatosis with polyangiitis. Starting from the observation of highly expressed periostin in the lesions of these diseases, periostin studies have expanded to include how periostin contributes to the generation of allergic phenotypes, how measurement of periostin is useful as a biomarker for allergic diseases, and recently how periostin inhibitors can improve allergic diseases. Periostin contributes to the generation of allergic phenotypes by acting as a matricellular protein on many cells, including both non-immune and immune cells. Based on the characteristics of periostin as a surrogate biomarker of interleukin-13, a signature cytokine of type 2 inflammation, serum periostin has been used as a biomarker for stratifying endotypes, estimating disease severity, predicting or monitoring the efficacy of therapeutic drugs, and predicting disease relapse or recurrence. Moreover, a lot of attention is now being paid to periostin in body fluids such as tears and sputum as a biomarker directly reflecting type 2 inflammation. Since it has been shown that periostin evokes itch in AD, we hope to see the development of a novel therapeutic agent for AD targeting periostin/αvβ3 integrin. Here we summarize the discovery and characteristics of periostin, as well as questions and/or problems regarding periostin that remain to be resolved.
2026-08-03 | An interdisciplinary framework for management of ocular allergy: Integrating the allergist in clinical practice.
Ocular allergy represents one of the most frequent yet under-recognized manifestations of pediatric allergic disorders, affecting up to 30% of children worldwide. The disease encompasses a spectrum ranging from mild, intermittent seasonal or perennial allergic conjunctivitis to severe, vision-threatening forms such as vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). Despite its high prevalence and the strong association with systemic allergic diseases-including asthma, allergic rhinitis, and atopic dermatitis-the involvement of pediatric allergists in routine ocular allergy care remains limited. This review proposes an interdisciplinary framework that integrates allergists more centrally into ocular allergy management. A structured approach to diagnosis highlights the allergist's essential role in identifying systemic triggers, performing allergy testing, and differentiating ocular allergy from mimics such as viral conjunctivitis, blepharitis, and autoimmune ocular surface disease. Management, as a stepwise, collaborative strategy beginning with allergen avoidance and topical dual-acting antihistamine/mast-cell stabilizers, progressing to steroid-sparing immunomodulators, systemic therapy, and advanced options such as allergen immunotherapy, emerging biologic treatments, including omalizumab and dupilumab, is discussed in the context of severe VKC and AKC, along with benefits, limitations, and need for ophthalmic oversight. This framework underscores the importance of timely referral from ophthalmologists to pediatric allergists, co-management of complex cases, and early integration of systemic allergy care. Through interdisciplinary collaboration, long-term visual outcomes can be improved and inappropriate steroid use minimized. A practical interdisciplinary care pathway and treatment escalation algorithm are proposed to facilitate real-world collaborative management.
2026-07-01 | Efficacy of topical 0.05% cyclosporine in Vernal Keratoconjunctivitis in children aged 5-15 years visiting outpatient department
Purpose:To assess the effectiveness and safety of short-term use of topical 0.05% cyclosporine in children with Vernal Keratoconjunctivitis (VKC).Study Design: Quasi experimental study. Place and Duration of Study: Sheikh Zayed Medical College and Hospital in Rahim Yar Khan from April 2025 to September 2026. Methods: A Consecutive sampling was done to include 78 children of 5-15 years of age who had clinically identified VKC. The analysis involved one eye of each patient. They were treated with the topical cyclosporine 0.05% eye drops four times per day for one month. The severity of the disease was evaluated using a validated clinical scoring system that included symptoms and indicators at baseline and after one month. Treatment was considered effective if there was at least one point improvement in the total VKC score from baseline. Results: There were 65.4% males. The total VKC score dropped significantly from the baseline of 10.0 [IQR: 8.0-13.0] to 4.0 [IQR: 2.0-6.0] after one month (p <0.001). Clinical improvement was noted in 69 patients (88.5%). No substantial differences in treatment response were observed based on age, gender, duration of symptoms, or daily computer usage. A mild, temporary burning sensation was observed in 7% of individuals. Conclusion: Topical 0.05% cyclosporine provided substantial short-term therapeutic improvement and exhibited a positive safety profile in pediatric patients with VKC.Larger, randomized controlled trials with longer follow-up are needed to confirm these preliminary findings and to establish the long-term role of this treatment in VKC management.
2026-07-01 | Clinical Profile and Recurrence Patterns of Vernal Keratoconjunctivitis in a Tertiary Care Setting
Abstract Background: Vernal keratoconjunctivitis (VKC) is a chronic allergic condition of the ocular surface that primarily affects youngsters in the tropical and subtropical areas. Understanding how diverse anatomical disease patterns influence recurrence is critical for effective therapy. The purpose of this study was to investigate the clinical profile of VKC patients and determine the relationship between illness pattern and recurrence of episodes. Materials and Methods: This hospital-based, cross-sectional, and observational study included 132 VKC patients presenting to a tertiary care ophthalmology center. Patients were classified into limbal, palpebral, or mixed patterns based on anatomical involvement. Demographic data, clinical features, and episode patterns (initial vs. recurrent) were recorded. The Chi-square tests assessed the associations between disease pattern and clinical variables. Results: The cohort comprised 85 males (64.39%) and 47 females (35.61%), with 72.73% aged ≤10 years. Itching (81.82%) and redness (66.67%) were predominant symptoms. Limbal VKC was most common (59.09%), followed by mixed (24.24%) and palpebral (16.67%) patterns. Overall recurrence rate was 78.79%, with mixed pattern showing highest recurrence (93.75%) and palpebral the lowest (54.55%). Disease pattern showed highly significant association with the type of episode ( χ 2 = 12.05, P = 0.002). Palpebral VKC presented more commonly as initial episodes (35.71%), while mixed pattern was strongly associated with recurrence (28.85% in recurrent vs. 7.14% in initial episodes). Conclusion: VKC demonstrates distinct clinical phenotypes with significant association between disease pattern and chronicity. Mixed VKC was significantly associated with higher recurrence rates and greater symptom burden in this cohort. Disease pattern was significantly associated with recurrence and symptom burden in this cross-sectional sample.
2026-06-27 | A clinical study on patterns of vernal keratoconjunctivitis among children in rural part of North-East India
Objectives: The objective of the study is to evaluate the demographic profile, clinical patterns, and environmental risk factors of vernal keratoconjunctivitis (VKC) among children attending a tertiary care center in a rural region of North-East India. Material and Methods: This hospital-based descriptive cross-sectional study was conducted from February 2024 to January 2025. It included 100 children (aged 0–18 years) clinically diagnosed with VKC. Data regarding demographics, clinical signs, symptoms, and environmental exposures (including cooking fuel and animal contact) were collected using a structured pro forma. Results: The mean age of presentation was 12.02 years, with a significant male preponderance (male: female ratio 2.03:1). Symptom exacerbation peaked in May. The most common symptom was intense itching (91%), and the most common sign was conjunctival hyperemia (88%). The Limbal variant was the predominant phenotype (72%). A significant association was observed with the use of firewood/kerosene for indoor cooking. Conclusion: VKC in North-East India predominantly affects young males and presents chiefly as the Limbal form. Indoor air pollution from biomass fuels is a significant modifiable risk factor in this rural population.
Access all drug discovery papers and probability of success in trials forecasts:
Access all drug discovery papers and probability of success in trials forecasts:
Drug Discovery Landscape
10 orphan drug designations for Vernal keratoconjunctivitis, including 4 approved therapies.
10 orphan drug designations for Vernal keratoconjunctivitis, including 4 approved therapies.
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
Tacrolimus monohydrate | small molecules | EMA | 2026-03-25 | — | Laboratoires Thea |
tacrolimus | small molecules | FDA | 2026-03-08 | — | OcuNeo Therapeutics Inc. |
gleceparin | small molecules | FDA | 2026-01-15 | — | NexEos Diagnostics Inc. (dba NexEos Bio) |
Tacrolimus | small molecules | FDA | 2020-06-03 | — | CN2 Therapeutics, Inc. |
cyclosporine [Verkazia] | small molecules | FDA | 2007-05-04 | 2021-06-23 | Harrow Eye, LLC |
Ciclosporin [Verkazia] | small molecules | EMA | 2006-04-06 | 2018-07-10 | Santen Oy |
TACROLIMUS HYDRATE | small molecules | EMA | 2004-01-14 | — | [INACTIVE] Sucampo Pharma Europe Limited |
Lodoxamide tromethamine [Alomide Ophthalmic Solution] | small molecules | FDA | 1991-10-16 | 1993-09-23 | Alcon Laboratories, Inc. |
Levocabastine HCl ophthalmic suspension 0.05% | small molecules | FDA | 1988-02-29 | — | Iolab Pharmaceuticals |
Cromolyn sodium 4% ophthalmic solution [Opticrom 4% ophthalmic solution] | small molecules | FDA | 1985-07-24 | 1984-10-03 | Fisons Corporation |
Let's accelerate rare disease drug discovery
Let's accelerate drug discovery
Get access to Explority AI's forecasts to outperform average preclinical success rates. Whether you're expanding your R&D pipeline, evaluating a partnership, or simply have a question — we'd love to hear from you.