A survey of vernal keratoconjunctivitis and other eosinophil-mediated external eye diseases amongst Palestinians

Abstract

PURPOSE. To determine the morbidity of vernal, atopic and other disease mediated by eosinophils amongst the Palestinian Community of East Jerusalem, West Bank and Gaza Strip. METHOD. In a prospective outpatient study, 840 people were screened for evidence of eosinophilic external eye disease by history taking and medical examination of the external eye, conjunctiva, nose and paranasal sinuses in the outpatient clinic. The surgical and iatrogenic morbidity of the condition was concurrently estimated, and the prescribing habits of local West Bank ophthalmologists were carefully evaluated. The favoured regime was locally manufactured antihistamine drops, usually in combination with an aminoglycoside antibiotic that characteristically exacerbates the condition. Topical steroids, such as guttae prednisolone forte, were also overused as a modality to treat the condition. CONCLUSIONS. Since the recent decline of endemic trachoma, vernal eye disease is now the leading cause of outpatient ophthalmic morbidity amongst Palestinians of East Jerusalem. The disease accounts for at least 9.8% of approximately 74,400 annual outpatient attendances to ophthalmic clinics in East Jerusalem, the West Bank and Gaza. The manifestations of the disease, however, are more protean than this. In the context of poor hygiene and sometimes dubious medical practice, vernal eye disease is often responsible for serious anterior segment and external ophthalmic disease.