Vernal keratoconjunctivitis (VKC) is a seasonal disorder, predominantly seen in male children with a history of atopy. It results in inflammation of the cornea and conjunctiva.
There are two subtypes of VKC, palpebral and limbal. Palpebral VKC primarily involves the palpebral conjunctiva, resulting in diffuse papillary hypertrophy most prominent on the upper lid. In severe cases, as seen in the top photograph, cobblestone-like giant papillae can form on the upper tarsus. Corneal changes may be associated with the tarsal lesions including superior pannus and superior or central "shield ulcers," as seen in the bottom photograph.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.