Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, allergic conjunctivitis with episodes of acute exacerbations. Although VKC has a self-limiting course, chronic recurrent inflammation can cause long-term visual impairment due to corneal complications including shield ulcers, infectious keratitis, keratoconus, corneal opacities, and limbal stem cell deficiency. The initial step in the management of corneal involvement is medical treatment of the acute stage of VKC and prevention of recurrences. Giant papillae not responding to medical treatment can be removed surgically in the case of corneal involvement. Shield ulcer with no inflammatory plaque usually heals with appropriate medical therapy. For shield ulcer with inflammatory plaque, however, surgical debridement with or without amniotic membrane transplantation might be necessary. Keratoconus may develop in chronic and severe VKC. An annual evaluation of these patients with corneal topography and/or tomography is essential for early detection of keratoconus and its timely management that includes collagen cross-linking and intrastromal corneal ring segment implantation. Corneal transplantation may be required in the advanced stage of keratoconus. Both penetrating keratoplasty and deep anterior lamellar keratoplasty can result in excellent visual outcomes in keratoconic eyes with concomitant VKC. Appropriate management of inflammation in the perioperative period is crucial for achieving successful outcomes after corneal transplantation. Limbal stem cell deficiency, a rare complication of long-standing and severe VKC, might be treated with living-related conjunctival limbal allograft.

春季角膜结膜炎（VKC）是一种慢性，双侧，过敏性结膜炎，伴有急性加重发作。尽管VKC具有自限性病程，但由于角膜并发症（包括盾状溃疡，感染性角膜炎，圆锥角膜，角膜混浊和角膜缘干细胞缺乏症），慢性复发性炎症可导致长期视觉受损。处理角膜受累的第一步是对VKC急性期进行药物治疗并预防复发。在角膜受累的情况下，可以通过手术切除对治疗无反应的巨型乳头。没有炎症斑块的盾状溃疡通常可以通过适当的药物治疗来治愈。但是，对于有炎性斑块的盾形溃疡，可能需要行或不行羊膜移植的清创术。圆锥角膜可能在慢性和严重的VKC中发展。对这些患者进行角膜地形图和/或断层扫描的年度评估对于早期发现圆锥角膜及其及时处理（包括胶原蛋白交联和基质内角膜环段植入）至关重要。圆锥角膜的晚期可能需要角膜移植。穿透性角膜移植术和深层前角膜角膜移植术均可在圆锥形角膜合并VKC的眼中获得出色的视觉效果。围手术期适当的炎症处理对于角膜移植成功取得成功至关重要。肢体干细胞缺乏症是长期和严重VKC的罕见并发症，可以用与生活有关的结膜缘同种异体角膜缘移植治疗。