Table 4.
Clinical grading of vernal keratoconjunctivitis and therapeutical approach
| Grade | Clinical findings | Treatment |
|---|---|---|
| 0 (quiescent) | Absence of symptoms | No treatment |
| 1 (mild) | Presence of symptoms with no corneal involvement | Anti-allergic eye drops daily |
| 2 (moderate) | Presence of symptoms associated with photophobia with no corneal involvement | Combined anti-allergic eye drops daily |
| 3 (severe) | Presence of symptoms associated with photophobia and mild to moderate SPK | Anti-allergic eye drops daily with pulsed low-dose topical steroid |
| 4 (very severe) | Presence of symptoms associated with photophobia and diffuse SPK or corneal ulcer | Pulsed high-dose topical steroid with eventual surgical removal of corneal plaque |