SUMMARY Aim: The aim of the study was to compare tear immunoglobulin E (IgE) levels of children with vernal keratoconjunctivitis (VKC) with those without VKC, with a view to determining any differences in tear IgE levels between these children. Materials and methods: It is a hospital-based case-control study of children presenting newly to the Eye clinics of Ring Road State Hospital and University College Hospital both in Ibadan, Oyo State, with acute symptoms of VKC. Children aged 3 to 16 years, sex and age matched with controls were recruited into the study between December 2009 and April 2010. A total of 81 children were included in the study (40 cases and 41 controls). All participants had administration of a structured questionnaire and detailed ocular examination. In addition to demographic data, information was sought from the cases regarding duration of symptoms of VKC, history of systemic atopic features, family history of allergy, history of previous treatment and current medications. Tears were collected from both eyes of cases and controls with capillary tubes from the inferotemporal cul de sac of the conjunctiva .The tear samples were analyzed for IgE using the Enzyme Linked Immunosorbent Assay (ELISA) technique. Results: The mean tear IgE level in cases was 8.26 ± 3.74 ng/ml (range 3 to 200ng/ml) and in controls 3.09 ± 1.33 ng/ml. Almost all the controls (98%) had normal tear IgE levels of 0 to 3 ng/ml except one who had tear IgE level of 40 ng/ml in one eye. Tear IgE levels of cases with VKC was significantly higher than that of controls (p<0.001). Twenty five (62.5%) out of forty cases of VKC had elevated tear IgE levels (>3ng/ml) in at least one eye. However, only 40 (50%) of 80 eyes with VKC had elevated tear IgE levels of >3ng/ml. Tear IgE level was significantly higher in the younger age group of 8-12 years (mean=12.87± 4.55ng/ml) than in older children of 13-16 years (mean=3.70 ± 1.61ng/ml) (p=0.02). There was however no statistically significant difference in tear IgE level with respect to the severity of VKC (p=0.27).