Question

What is the diagnosis for ropy discharge from the eyes, along with itching, which occurs every summer?

• A. Vernal catarrh
• B. Bacterial conjunctivitis
• C. Trachoma
• D. Phlyctenular conjunctivitis

Hint:

Seasonal itching with thick, stringy discharge in summer is the classic picture of an allergic eye disease.

Answer 1

The Correct Option is A

Step 1: Pick out the key features.
Three clues matter here: the discharge is ropy or stringy (thick mucoid strands), there is itching, and the problem comes back every summer.

Step 2: Recall vernal catarrh (vernal keratoconjunctivitis).
Vernal catarrh is a seasonal, IgE mediated allergic eye disease, most active in warm, dry months such as summer. Its hallmark symptom is intense itching, along with a thick, ropy (stringy) mucoid discharge, cobblestone papillae on the upper tarsal conjunctiva, and photophobia. It is more common in young boys and tends to recur each year in the same season.

Step 3: Rule out bacterial conjunctivitis.
Bacterial conjunctivitis gives a purulent, thick yellow-green discharge that is sticky rather than ropy, with redness and crusting of lashes on waking. It is not typically itchy, and it does not follow a strict seasonal summer pattern.

Step 4: Rule out trachoma.
Trachoma is a chronic infection from Chlamydia trachomatis. It causes follicles and scarring on the upper tarsal conjunctiva that over years can lead to lid scarring and entropion. It is not marked by itching or ropy discharge, and it is not a seasonal condition.

Step 5: Rule out phlyctenular conjunctivitis.
Phlyctenular conjunctivitis presents as tender limbal nodules with photophobia and watering, usually linked to TB hypersensitivity, not itching with ropy discharge, and it is not tied to a specific season.

Step 6: Final answer.
The itching, ropy discharge, and yearly summer recurrence point to vernal catarrh.
\[ \boxed{\text{Vernal catarrh}} \]