# The evolving role of ciclosporin in the management of vernal keratoconjunctivitis

## TL;DR

This paper discusses the development and use of ciclosporin as a safer alternative to steroids for treating vernal keratoconjunctivitis, a severe eye condition in children.

## Contribution

The paper outlines the journey to developing an unpreserved ciclosporin formulation for human eye use.

## Key findings

- Ciclosporin provides symptom relief and controls ocular inflammation without the side effects of steroids.
- The development of an unpreserved ciclosporin formulation for the eye was a lengthy process.
- Ciclosporin helps avoid issues like raised intraocular pressure and cataract formation caused by steroids.

## Abstract

In the spectrum of allergic eye disease, vernal keratoconjunctivitis (VKC) is classed as one of the most severe disease entities and can have profound effects on visual development as well as on the emotional and psychological well-being of afflicted children. The traditional mainstay of treatment for the condition, to control the ocular inflammation, has been steroids but the use of these drugs has not been without side effects. Ciclosporin offers an alternative to steroids, providing symptom relief and control of the ocular inflammation, whilst averting the problems associated with raised intraocular pressure, cataract formation and reactivation of herpes simplex keratitis, all recognised side effects of topical steroids. However, the journey to the development of a formulation of an unpreserved ciclosporin for use in human eyes has been a protracted one; the aim of this article is to outline this journey and the role of ciclosporin in the modern management of this debilitating disease.