A 10 year old boy presents with severe itching of the eye and a ropy discharge. His symptoms aggravate in summer season. Most likely diagnosis is?
**Core Concept**
Vernal keratoconjunctivitis (VKC) is a seasonal allergic eye disease characterized by severe itching, a ropy discharge, and inflammation of the conjunctiva. It is most commonly seen in children and adolescents, particularly during the spring and summer months.
**Why the Correct Answer is Right**
VKC is caused by an allergic response to environmental allergens such as pollen, dust, and mold. The symptoms worsen during the summer season due to increased exposure to these allergens. The ropy discharge is a hallmark feature of VKC, resulting from the accumulation of mucous and inflammatory cells on the conjunctiva. The severe itching is due to the release of histamine and other chemical mediators from mast cells, which are activated by the allergens.
**Why Each Wrong Option is Incorrect**
**Option A:** Trachoma is a chronic keratoconjunctivitis caused by Chlamydia trachomatis, but it is typically seen in areas with poor sanitation and is not seasonal.
**Option B:** Conjunctivitis caused by viral or bacterial pathogens may present with a similar discharge, but it is usually accompanied by other symptoms such as redness, swelling, and tearing.
**Option C:** Allergic rhinitis may coexist with VKC, but it does not cause the severe eye symptoms characteristic of VKC.
**Clinical Pearl / High-Yield Fact**
VKC is often associated with other allergic conditions such as asthma and atopic dermatitis, highlighting the importance of a comprehensive evaluation of the patient's overall allergic profile.
**Correct Answer:** C.