Vernal keratoconjunctivitis (VKC) is a relatively rare but severe allergic eye disorder mainly affecting 5–17-year-old males. It generally resolves with puberty, and seasonal variability can be noted. Flares and quiescent phases are unpredictable and can affect both eyes. If VKC is not adequately managed during the active phase, sight can be threatened. Timely intervention and frequent monitoring of VKC are crucial as the consequences of poor management and/or treatment can be devastating to the patients involved.1-4 VKC is rare, affecting 1 in 10,000 children each year.
A VKC quality of life questionnaire exists that was developed and validated by Italian researchers for use with older adolescents (the QUICK questionnaire).5 This was translated into English language with a pictorial representation of VKC symptoms for use by young patients in collaboration with the original authors of QUICK. Young VKC patients and unaffected individuals (recruited from the hospital Youth Forum) were asked to review the translated questions and provide opinions on whether the questions were easy to understand, and if the pictures
represented the questions asked adequately.
Alterations were made based on this feedback and an electronic application compatible with the Apple iOS and Android platforms was created (eQUICK) linked to the hospital’s electronic patient administrative system. This was made available to patients on an invitation only basis to access either during consultations in the hospital or remotely. Young patients were able to use it with ease, enabling them to easily report symptoms first-hand to clinicians during routine appointments and whilst at home to report exacerbations or improvements in their condition.
The authors compared the symptoms recorded on eQUICK to three parameters routinely recorded in their clinic. These were:
> An ocular examination score adapted from the Shoji et al.6 scoring system.
> A treatment score which the authors have developed as a bespoke system.
> A rhino-conjunctivitis quality of life score adapted from the Juniper Adolescent
Rhino Conjunctivitis Quality of Life7
Using data from 11 patients, synchronous changes were found in both parameters (RCQoL and eQUICK) indicating correlation of 0.75. eQUICK was more sensitive in identifying symptom changes in children whose presenting symptoms are predominantly ocular. There was an inverse relationship between the treatment score and the eQUICK score, and a proportional relationship between ocular finding score and the eQuick
score. These results have been previously presented in a poster at the European Academy of Allergy and Clinical Immunology (EAACI) congress in Lisbon, Portugal, 2019.8