Superior limbic keratoconjunctivitis
Medical condition
From Wikipedia, the free encyclopedia
Superior limbic keratoconjunctivitis (SLK, Théodore's syndrome[1]) is a disease of the eye[2] characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva.[3] It was first described by F. H. Théodore in 1963.[4]
| Superior limbic keratoconjunctivitis | |
|---|---|
| |
| SLK develops due to repeated corneal microtrauma of the cornea and limbus | |
| Specialty | Ophthalmology |
| Symptoms | Eye redness, burning sensation, tearing |
| Duration | Chronic |
| Risk factors | Corneal microtrauma, hyperthyroidism, hyperparathyroidism |
| Treatment | Topical corticosteroids, artificial tears, surgery |
| Prognosis | Exacerbations decrease with age |
Symptoms and signs
Patients present with red eye, burning, tearing, foreign body sensation and mild photophobia.[5] Upon examination, the conjunctiva appears inflamed and thickened, especially at the limbus.[citation needed]
Pathophysiology
The development and pathophysiology of SLK is not well understood, but appears to involve microtrauma of keratoconjunctival surfaces.[6] This mechanical hypothesis is supported by the increased lid apposition of exophthalmic thyroid patients, who are known to have an increased incidence of superior limbic keratoconjunctivitis.[5]
Diagnosis
Treatment
First-line treatments include topical corticosteroids and artificial tears.[7] For non-responsive cases, potential treatments include topical ciclosporin A,[8] vitamin A,[9] autologous serum[10] and injections of triamcinolone.[11] Surgical treatment options include thermocauterization of the bulbar conjunctiva[12] and conjunctival resection,[13] typically under rose bengal (RB) staining to visualize affected areas.[7]
Epidemiology
Superior limbic keratoconjunctivitis tends to occur more often with dry eye syndrome (keratoconjunctivitis sicca), hyperthyroidism and hyperparathyroidism.[14] It is also a rare complication associated with rheumatoid arthritis.[3] Rarely, it may occur as a consequence of upper eyelid blepharoplasty surgery.[15]
