Superior limbic keratoconjunctivitis

Superior Limbic Keratoconjunctivitis (SLK) is a chronic eye condition characterized by inflammation of the superior limbus, the junction between the cornea and the sclera, and the adjacent conjunctiva. This condition predominantly affects the upper part of the eye and is known for its recurrent nature. The exact cause of SLK is not well understood, but it is believed to be associated with various factors including thyroid disease, particularly Graves' disease, mechanical factors such as eyelid abnormalities or contact lens wear, and environmental factors like dry air or pollutants.

Symptoms

Patients with Superior Limbic Keratoconjunctivitis may experience a range of symptoms, including:

• Redness and irritation in the upper part of the eye
• Sensation of a foreign body in the eye
• Tearing
• Photophobia (sensitivity to light)
• Mucous discharge

Diagnosis

Diagnosis of SLK involves a comprehensive eye examination. Key diagnostic features include thickening and redundancy of the superior conjunctival tissue, fine papillary hypertrophy on the superior tarsal conjunctiva, and punctate staining of the superior cornea with fluorescein dye. In some cases, further testing may be required to assess the association with thyroid disease or other underlying conditions.

Treatment

Treatment of Superior Limbic Keratoconjunctivitis aims to alleviate symptoms and address any underlying conditions. Options may include:

• Artificial tears and lubricating ointments to manage dryness and irritation
• Topical anti-inflammatory medications, such as corticosteroids, to reduce inflammation
• Surgical interventions, such as thermocautery of the superior limbal conjunctiva, in severe or refractory cases
• Management of associated conditions, like thyroid disease, to potentially reduce SLK symptoms

Prognosis

With appropriate treatment, the prognosis for patients with SLK is generally good. However, due to its chronic and recurrent nature, long-term management may be necessary to control symptoms and prevent complications.

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