Paediatric allergy in the eye

Vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are types of allergic eye conditions which cause soreness, itching, redness of the eyes and eyelids and occasionally blurry vision.

The conditions are very similar to eczema but affect the membrane of the eye and inside the eye lids (the conjunctiva) instead of the skin. Like eczema, it can continue for some time (months to years) but most young people grow out of it.

What causes it?

If you or your family have allergic diseases such as eczema or asthma, your child is more likely to get an eye allergy. Everyone has an immune system (for instance antibodies) which helps to fight off germs that could cause infections.

Allergic diseases happen when the immune system reacts to harmless substances like dust or pollen. In some people it affects breathing (asthma), the skin (eczema) and, less commonly, the eyes. Allergy tests are not helpful. This is because most people affected have allergies to many things in the environment but, as with asthma and eczema, knowing this does not help treat the problem.


Anti-allergy drops need to be used regularly every day. They should not be stopped unless you have been advised to do so. This applies even if your child’s eyes feel better, as the problem may return or even cause eye damage. Some children need drops only for a few weeks in hot weather; some need them during the whole spring and summer, while others need them all year round. If there is eczema on the eyelid skin, you could be asked to use cream or ointment to treat it. Please note-it is very important to discourage your child from rubbing or scratching their eyes as this will make the condition worse.

Sometimes, the edges of the eyelids are very sore. This is a sign of blepharitis and your child may need some treatment for this (see blepharitis leaflet for more information). If your child’s eyes are very inflamed or the window of the eye (cornea) is affected, this can affect their sight and stronger drops such as steroids may be prescribed. Steroids usually make eyes feel better quickly, but they can have side effects so it is important that these drops are used exactly as prescribed.

Please also ensure that you keep your child’s appointments in the clinic.

At Moorfields and other large eye units, we have used a drug called ciclosporin A for many years in children and adults with severe allergic eye diseases.

Using ciclosporin A drops or ointment often lessens the need for steroid eye drops. The drop is very safe but was previously not licensed. It is now available in a licensed drop form for adults and we use this regularly ’off license’ for children. However, we are expecting a license agreement for children to be released very soon. Once your child has been started on this medication, your general practitioner should issue a repeat prescription.

Please contact the consultant in charge of your child’s care if there are any problems getting this.

Further check-ups

In some cases, your doctor may be able to discharge your child straight from A&E and there will be no need to return for a check-up. In other cases, your child may need regular eye clinic check-ups.

What to look out for:

  • Painful eyes
  • Redness, swelling and itching which is getting a lot worse
  • Vision which is becoming worse over time

If you are worried, please call the advice line opposite or attend A&E for a further examination.

A&E for children is located in the Richard Desmond Children’s Eye Centre

Opening hours: 9am - 4pm, Monday to Friday.

Outside of these hours, please attend the adult A&E department at Moorfields City Road (around the corner).

Richard Desmond Children's Eye Centre

The Richard Desmond Children's Eye Centre is our dedicated children's hospital. It is based on the same campus as the main hospital in London's City Road, but has a separate entrance in Peerless Street.


Richard Desmond Children's Eye Centre, Moorfields Eye Hospital.

3 Peerless Street




Call 0207 253 3411

Author: Paediatric information group

Review date: July 2024