Specific clinical features of atopic keratoconjunctivitis are well known in adults and lead to a severe ocular surface impairment. However in children’s keratoconjunctivitis, even if common vernal keratoconjunctivitis form predominates, some pediatric presentation differs and must be individualised. A complete clinical evaluation has to be precised for a better knowledge of the prognosis of the disease. Different new explorations physiopathological mechanisms are detailed in the pathology. This evaluation allows a better adjustment of the treatment.