Vesicular keratoconjunctivitis is a delayed allergic reaction to microbial proteins, commonly seen in children with acute blepharitis, bacterial conjunctivitis, malnutrition, and weakness, and is prone to recurrence. Vesicular nodules of the bulbar conjunctiva are mostly located in the lid fissure area and are grayish-red, 1-4 cm in diameter, surrounded by congestion and easily ulcerated apically to form an ulcer; vesicular nodules of the corneal limbus are the most common, with a grayish-white triangular or round corneal infiltrate, limited congestion of the surrounding bulbar conjunctiva, and limited cloudiness remaining on the corneal side after rupture and healing. Corneal rim vesicles can develop towards the central cornea, forming a band of cloudiness with central neovascularization, which can easily be misdiagnosed as viral keratitis.