Tear Tryptase in Vernal Keratoconjunctivitis

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Abstract
VERNAL keratoconjunctivitis (VKC) is a form of chronic allergic conjunctivitis that is potentially blinding by the complications of the disease or by the long-term use and abuse of topical corticosteroids. Patients with VKC have an increase in the number of eosinophils, mast cells, and other inflammatory cells in the conjunctiva. The diagnosis of ocular allergy in most cases remains clinical. There are no specific and sensitive diagnostic assays for ocular allergy. Tryptase is a neutral protease that has been shown to selectively concentrate in the granules of human mast cells. It is well known that mast cells play a pivotal role in the pathogenesis of VKC. Determination of granule products of mast cells in tears of patients with allergic conjunctivitis may reflect the degree of activation of the mast cell.1-4 The release of tryptase in tears may serve as a clinical marker for mast cell activation and for monitoring of ocular allergy following treatment. Recent studies have shown that mast cells have structural and functional heterogeneity.5-7

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