Superior limbic keratoconjunctivitis

An overview of Superior Limbic Keratoconjunctivitis

Superior Limbic Keratoconjunctivitis

Diagram of the human eye showing the limbus

Superior Limbic Keratoconjunctivitis (SLK) is a chronic inflammatory condition of the eye, specifically affecting the superior limbus and the adjacent bulbar conjunctiva. It is characterized by recurrent episodes of redness, irritation, and discomfort in the affected eye.

Pathophysiology

SLK is believed to result from mechanical irritation of the superior limbus. This irritation may be due to abnormal lid anatomy or movement, leading to friction between the eyelid and the ocular surface. The condition is often associated with thyroid eye disease, particularly in patients with Graves' disease.

Clinical Features

Patients with SLK typically present with symptoms of burning, foreign body sensation, and photophobia. On examination, there is often hyperemia of the superior bulbar conjunctiva, punctate epithelial erosions, and thickening of the conjunctiva. The superior limbus may appear inflamed and edematous.

Diagnosis

The diagnosis of SLK is primarily clinical, based on the characteristic signs and symptoms. Slit-lamp examination is crucial for identifying the superior conjunctival changes and limbal involvement. Fluorescein staining may reveal punctate epithelial erosions in the superior cornea.

Management

Management of SLK involves addressing the underlying mechanical irritation. Treatment options include:

• Lubricating eye drops to reduce friction
• Topical anti-inflammatory medications
• Punctal occlusion to increase tear film stability
• Surgical intervention in severe cases, such as conjunctival resection

Prognosis

The prognosis for SLK is generally good with appropriate management. However, the condition can be chronic and recurrent, requiring ongoing treatment and monitoring.

Related pages

• Conjunctivitis
• Keratitis
• Thyroid eye disease