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Superior Limbic Keratoconjunctivitis

SLK


Presentation

  • A 48-year-old woman presented with a 2-year history of irritation and foreign body sensation in both eyes that began immediately after bilateral upper eyelid blepharoplasty.[ncbi.nlm.nih.gov]
  • Positive skin and ocular sensitivity reactions to thimerosal were present in one-third (5/15) of patients tested.[ncbi.nlm.nih.gov]
  • Participants were 13 patients (26 eyes) with ocular cGVHD and SLK-like inflammation presenting to the University of Illinois at Chicago and BostonSight between January 1, 2009 and July 1, 2013.[ncbi.nlm.nih.gov]
  • 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.Patients present with red eye, burning, tearing, foreign body[en.wikipedia.org]
  • We report the clinical presentation and management of SLK in a 7-year-old boy who responded well to topical steroids and lubricants.[ncbi.nlm.nih.gov]
Recurrent Inflammation
  • Superior limbic keratoconjunctivitis is an ocular disease characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva.Even though the pathophysiology remains unclear,[en.wikipedia.org]
  • From Wikidata Jump to navigation Jump to search ocular disease characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva Theodore's superior limbic keratoconjunctivitis[wikidata.org]
  • Superior limbic keratoconjunctivitis Definition from Encyclopedia Dictionaries & Glossaries English Wikipedia - The Free Encyclopedia Superior limbic keratoconjunctivitis is an ocular surface disease characterized by episodes of recurrent inflammation[dictionary.babylon-software.com]
  • Superior limbic keratoconjunctivitis is an ocular surface disease characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva.[ipfs.io]
  • Superior limbic keratoconjunctivitis A condition characterised by episodes of recurrent inflammation of the superior cornea, the junction between the cornea and the sclera (the limbus), and the conjunctiva lining the superior sclera and inner surface[ue.termwiki.com]

Workup

  • 20mm Left: 15mm Differential Diagnosis Superior limbic keratoconjunctivitis Superior conjunctivochalasis Keratoconjunctivitis Sicca Allergic conjunctivitis Dry Eye Syndrome Episcleritis Viral conjunctivitis Trachoma Ocular Surface Neoplasia Further workup[webeye.ophth.uiowa.edu]

Treatment

  • Most recently, studies have suggested that lacrimal occlusion therapy may be beneficial in the treatment of SLK. A case is presented in which this method of treatment was used, with excellent results.[ncbi.nlm.nih.gov]
  • Topical CsA 0.05% can be effective in patients with SLK who do not respond to other treatment modalities. It can also be used in the long term to prevent recurrences during treatment and to avoid steroid dependency and the side effects of steroids.[ncbi.nlm.nih.gov]
  • Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.[ncbi.nlm.nih.gov]
  • RESULTS: Twenty-eight eyes showed complete disappearance of SLK after treatment (84.8%; P .001).[ncbi.nlm.nih.gov]
  • PURPOSE: To evaluate the efficacy of supratarsal triamcinolone injection in the treatment of superior limbic keratoconjunctivitis (SLK). METHODS: Forty eyes of 20 patients were diagnosed with SLK.[ncbi.nlm.nih.gov]

Prognosis

  • In general, the prognosis for superior limbic keratoconjunctivitis is excellent, with remission as the natural history and eventual total resolution, although symptoms may last for years.[thehealthscience.com]
  • Prognosis of SLK is good after proper treatment. Causes Of Superior Limbic Keratoconjunctivitis The exact etiopathogenesis of superior limbic keratoconjunctivitis is not known.[tandurust.com]
  • Prognosis: In general, prognosis for superior limbic keratoconjunctivitis is excellent. With increasing age, exacerbations tend to diminish in frequency with eventual total resolution, though symptoms may last for years.[nhp.gov.in]
  • Prognosis Remissions and exacerbations tend to diminish in frequency as age increases. American Academy of Ophthalmology.[eyewiki.aao.org]

Etiology

  • Both the etiology and the pathogenesis of this condition are poorly understood.[ncbi.nlm.nih.gov]
  • Although the etiology of SLK is unknown, these patients support the theory of a mechanical cause for SLK.[ncbi.nlm.nih.gov]
  • Exposure to thimerosal is implicated in the etiology of contact lens-superior limbic keratoconjunctivitis (CL-SLK).[ncbi.nlm.nih.gov]
  • PURPOSE: To determine the pathophysiological etiology of superior limbic keratoconjunctivitis (SLK), we compared the superior limbic conjunctivae of SLK patients and normal controls.[ncbi.nlm.nih.gov]
  • PURPOSE: Superior limbic keratoconjunctivitis (SLK) is a disease of unknown etiology which showed various degrees of keratinization.[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiology: Most common in adult women 20-70 years old. Clinical: A bilateral and localized process confined to the superior limbal area and tarsus from the 10-2 o'clock position.[missionforvisionusa.org]
  • The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 1994;92:477-588. [ PUBMED ] [ FULLTEXT ] [Figure 1], [Figure 2], [Figure 3][meajo.org]
  • It is a chronic recurrent disease affecting the superior bulbar and pal-pebral conjunctiva and the adjacent cornea, in the form of epithelial punctate keratitis that can be filamentary. 6 – 9 Epidemiology Superior limbic keratoconjunctivitis affects all[entokey.com]
  • The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc. 1994;92:477-588. 8. Wilson FM, Ostler HB. Superior limbic keratoconjunctivitis.[ophthalmologymanagement.com]
  • Epidemiology Women men (3:1) 20-60 years of age No predilection for a specific race Associated with thyroid dysfunction and keratoconjunctivitis sicca Good prognosis: eventually clears Signs/Symptoms Gritty foreign body sensation Hyperemia Irritation[webeye.ophth.uiowa.edu]
Sex distribution
Age distribution

Pathophysiology

  • Superior limbic keratoconjunctivitis is an ocular disease characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva.Even though the pathophysiology remains unclear,[en.wikipedia.org]
  • PURPOSE: To determine the pathophysiological etiology of superior limbic keratoconjunctivitis (SLK), we compared the superior limbic conjunctivae of SLK patients and normal controls.[ncbi.nlm.nih.gov]
  • Even though the pathophysiology remains unclear, it is thought that mechanical trauma from tight upper lids or loose redundant conjunctiva could lead to the disruption of normal epithelium.[ipfs.io]
  • Conjunctivitis Atopic Keratoconjunctivitis Bacterial Conjunctivitis Emergent Treatment of Acute Conjunctivitis Epidemic Keratoconjunctivitis Giant Papillary Conjunctivitis Keratoconjunctivitis Sicca Neonatal Conjunctivitis Viral Conjunctivitis Etiology and Pathophysiology[thehealthscience.com]
  • Pathophysiology SLK is believed to be present secondary to superior bulbar conjunctiva laxity, which induces inflammatory changes from mechanical soft tissue microtrauma4 In settings where the physiological tolerance of mechanical forces on the delicate[odlarmed.com]

Prevention

  • It may also be used as a maintenance drug to prevent recurrence. Further study may delineate the specific role and treatment parameters for the use of topical cyclosporine A 0.5% in the treatment of SLK.[ncbi.nlm.nih.gov]
  • Therapeutic soft contact lenses were used after pressure patching in the other six patients to prevent recurrences of SLK.[ncbi.nlm.nih.gov]
  • It can also be used in the long term to prevent recurrences during treatment and to avoid steroid dependency and the side effects of steroids.[ncbi.nlm.nih.gov]
  • Early recognition and management of SLK in ocular cGVHD can improve vision, reverse signs, and may prevent these long-term consequences. Copyright 2016 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • Superior Limbic Keratoconjunctivitis is an eye disorder of unknown cause, and hence it cannot be prevented However, certain steps can be taken to preserve the eye condition: Always maintain hygiene, wash hands regularly, and prevent aggravation of the[dovemed.com]

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