You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Cobblestone appearance is seen in: and explain in detail?
Ans: c (Vernal conjunctivitis) Ref: AK Khurana, 4th ed, p. 74Cobblestone( pavement stone)--typical arrangement of hard flat topped papillae in palpebral conjunctivaVernal keratoconjunctivitisPhlyctenular conjunctivitis* Exogenous allergen(dust, pollen)* Type I HS* Bilateral* Endogenous microbial proteins(TB, staph)* Type IV HS(Delayed HS)* unilateral* C/F:itching, lacrimation, photophobia, ropy discharge (Maxwell lyon sign)* C/F; irritation, reflex lacrimation, discomfort(itching not marked)Conjunctival signsPalpebralCobblestone appearanceFollicles are not seenBulbar signsGelatinous limbusHomer tranta spotsDusky red triangular congestion Conjunctival signsPhlycten/nodule at limbus-characteristicConsists of subepithelial mononuclear infiltration in a triangular area with apex towards deeper margin* Nodules ulcerate at apex.Corneal signsEpithelial erosionSubepithelial punctate erosionPseudogerantoxon with classic cupid bow outlineCorneal signsFascicular ulcerMiliary ulcer(ring ulcer)Scrofulous ulcerUlcer may present. Rx : steroid dropsRx: steroid drops