Application of Autologous Artificial Tears in a Case of an 8-Year-Old Girl with Vernal Keratoconjunctivitis (Spring Catarrh)

Introduction

Vernal keratoconjunctivitis is a chronic, recurrent bilateral inflammation of the outer ocular layer. Mostly affected are children and young people and the condition is more common in boys. The disease presents with eye pruritus (itching eye), photophobia (sensitivity to bright light), excessive tearing and foreign eye syndrome. Severe cases manifest themselves with a diffusion of overgrown papillae usually of the upper eyelid, bursting/breaking of the connective tissue barriers and occurrence of giant papillae that press on the cornea. Corneal ulceration is a severe complication of vernal keratoconjunctivitis that may induce scarring, corneal neovascularization and occasionally perforation.

Treatment of keratoconjunctivitis mainly relies on steroids, mast cell stabilizers, antihistamines, immunosuppressive drugs (cyclosporine), artificial tears, contact lenses-dressing, cryotherapy and surgical papillae removal.

We present the case of an 8-year-old girl with corneal ulceration who was applied artificial tears after traditional methods of treatment proved unsuccessful.

Aim

The aim was to share our experience on artificial tears therapy applied in ophthalmic disorders.

Materials and methods

Autologous blood (20 ml) was collected into disposable, sterile transfer bags used for routine blood component preparation (no anticoagulant) and incubated for 1 hour at 37 °C.

The clot was then removed by centrifugation (13 min, 22°C, 3100 x g) and the serum containing erythrocytes was press extracted. Centrifugation was applied again (5 min, 22°C, 2000 x g) to obtain a serum that is free of cellular components. The serum was then divided into 0,3 ml segments (capsules) and the artificial tears were applied to the left eye 8 times per day.

Results

Ulcer healing was reported after 4 weeks of therapy with artificial tears. The dosage was reduced to 4 times per day. No recurrence of corneal ulceration was observed after subsequent 8 weeks.

Artificial tears are a safe and effective therapy for ophthalmic disorders in children.