Background:

In vernal keratoconjunctivitis, traditional treatments are sometimes insufficient for symptom control; the results with omalizumab are promising in resistant cases.

Case report:

15-year-old female adolescent with vernal keratoconjunctivitis who had received multiple ophthalmic treatments, immunotherapy and systemic steroids with no clinical response. She attended a clinical immunology and allergy department where she was started on omalizumab 225 mg every 2 weeks. After 6 months, she showed a decrease in pruritus and photophobia; two years later, both papillae and Horner-Trantas dots had disappeared. She remained symptom-free, and the use of ophthalmic drugs was therefore reduced. The patient missed omalizumab application on 4 occasions; however, symptoms recurred, and the papillae reappeared, but remitted upon drug re-initiation.

Conclusion:

There is a temporal relationship between omalizumab administration and ocular symptom control, with evidence of relapse upon discontinuation.