The exact cause of Superior Limbic Keratoconjunctivitis is unknown. They are thought to occur spontaneously, or due to certain morphological (anatomical) anomalies caused by abnormal thyroid function Constant or continuous mechanical problem/trauma associated with certain eye parts, chiefly the conjunctiva
Conjunctiva
The conjunctiva is a tissue that lines the inside of the eyelids and covers the sclera. It is composed of unkeratinized, stratified squamous epithelium with goblet cells, and stratified columnar epithelium. The conjunctiva is highly vascularised, with many microvessels easily accessible for imaging studies.
What are the risk factors for superior limbic keratoconjunctivitis?
Superior limbic keratoconjunctivitis can occur in anyone though it is more prevalent in females and middle aged individuals. Associated risk factors include: Thyroid disease such as hypothyroidism and hyperthyroidism. Graves’ disease. Scar formation on conjunctiva or cornea.
What is superior limbic keratoconjunctivitis of Theodore?
Superior limbic keratoconjunctivitis (SLK) of Theodore is a rare chronic inflammatory disease of the superior bulbar conjunctiva, limbus and upper cornea of unknown etiology. This disease has been associated with thyroid dysfunction, keratoconjunctivitis sicca and rheumatoid arthritis.
What are the symptoms of superior limbic keratoconjunctivitis?
Symptoms Of Superior Limbic Keratoconjunctivitis. Superior limbic keratoconjunctivitis usually occurs in both the eyes. Common symptoms and signs of this condition are as follows: Dryness in eye. Itching and burning sensation in eyes. Pain in eyes. Redness and inflammation of the upper eyelid.
What is SLK (superior limbic keratoconjunctivitis)?
Superior limbic keratoconjunctivitis (SLK) is a chronic recurrent inflammatory disease of eye, mainly affecting the cornea and the conjunctiva. Although the exact etiology of this condition is not known, it has been associated with many other conditions such as hypothyroidism, Graves disease, rheumatoid arthritis, keratoconjunctivitis, etc.
How common is superior limbic keratoconjunctivitis?
Superior limbic keratoconjunctivitis (SLK) is a relatively uncommon chronic disease of the superior limbus and the superior bulbar and tarsal conjunctiva. It affects one or both eyes of middle-aged women, approximately 50% of whom have abnormal thyroid function (usually hyperthyroidism).
What are the causes of keratoconjunctivitis?
Infectious keratoconjunctivitisEpidemic keratoconjunctivitis: This form is caused by an adenovirus and may also be called adenoviral keratoconjunctivitis. ... Bacterial keratoconjunctivitis: This form can be caused by many kinds of bacteria. ... Herpetic keratoconjunctivitis: This form is caused by herpes virus infections.More items...•
Is superior limbic keratoconjunctivitis rare?
Superior limbic keratoconjunctivitis (SLK) of Theodore is a rare chronic inflammatory disease of the superior bulbar conjunctiva, limbus and upper cornea of unknown etiology.
How is superior limbic keratoconjunctivitis treated?
Management. Medical treatment includes topical lubrication and/or topical steroids. In contact lens-related SLK, discontinuing contact lens wear for a period of time will improve the condition, while bandage soft contact lenses are beneficial for idiopathic SLK of Theodore.
Is keratoconjunctivitis serious?
With prompt attention, mild to moderate cases of keratitis can usually be effectively treated without loss of vision. If left untreated, or if an infection is severe, keratitis can lead to serious complications that may permanently damage your vision.
How long does keratoconjunctivitis take to heal?
Epidemic keratoconjunctivitis is a highly contagious infection of the front surfaces of the eye. There is no specific treatment, and symptoms usually resolve in about two weeks.
Is SLK an autoimmune disease?
Although the pathogenesis of SLK is still unknown, it is thought to be related to mechanical injury, tear film instability, or an autoimmune/inflammatory etiology. Many patients with SLK can be asymptomatic or have symptoms that resolve or remit spontaneously.
What is SLK surgery?
When noninvasive or less invasive treatment modalities fail in the treatment of superior limbic keratoconjunctivitis (SLK), surgical intervention is an alternative. Surgical resection of the involved conjunctiva—as delineated intraoperatively by the use of rose Bengal staining—removes the affected tissue.
How is VKC treated?
Mast cell stabilizers and antihistamines have been proven to be effective for the treatment of mild to moderate forms of VKC. In the most severe cases, topical steroids can be used as rescue medication to reduce conjunctival and corneal inflammation.
How do you treat a SLK?
SLK has been treated with silver nitrate or thermal cauterisation of the superior bulbar conjunctiva, pressure patching, and large diameter bandage contact lenses (BCL), topical trans-retinoic acid 0.1%, and recession or resection of the superior bulbar conjunctiva.
Does scleritis affect vision?
If it's not treated, scleritis can lead to serious problems, like vision loss. It also can be linked to issues with your blood vessels (known as vascular disease).
What causes thygeson's disease?
The pathophysiology of TSPK remains unknown. Both, viral and immunologic mechanisms have been implicated. Adenovirus, herpes simplex virus, and varicella zoster virus, have all been implicated as a possible causes of the disease.
What keratoconjunctivitis mean?
Keratoconjunctivitis refers to an inflammatory process that involves both the conjunctiva – conjunctivitis – and the superficial cornea – keratitis – which can occur in association with viral, bacterial, autoimmune, toxic, and allergic etiologies.
What is allergic keratoconjunctivitis?
Allergic conjunctivitis is inflammation of the conjunctiva, which is the tissue that covers the inside of eyelids, as well as the white part of the eyeball.
What is dry eye caused from?
Dry eye is a condition that occurs when tears cannot properly lubricate the eyes. This is caused by either a decrease in tear creation or an increase in tear evaporation. If not treated, dry eye can cause lasting damage to the corneal surface and declining vision.
Is atopic keratoconjunctivitis curable?
Atopic keratoconjunctivitis needs long-term treatment to prevent complications such as scarring of the cornea (the clear window at the front of the eye), which can damage sight. In the early stages of the disease, symptoms can be controlled by standard anti-allergy drugs.
What is the name of the eye disease that affects the tarsal conjunctiva?
Listen. Superior limbic keratoconjunctivitis (SLK) is a chronic and recurrent eye disease which affects the superior bulbar conjunctiva (the clear layer that covers the eyeball, over the sclera) and tarsal conjunctiva (the clear layer that lines the eyelids), as well as the superior limbic aspect of the cornea (the area above the cornea ).
What causes SLK?
One of the most common theories suggests that the development of SLK is related to laxity or a loosening of the superior bulbar conjunctiva (the clear layer that covers the eyeball, over the sclera ), resulting in friction and inflammation (swelling) between the upper eyelid and the eyeball. However, like other theories previously proposed, such as infectious, immunogenic and allergic, this theory lacks sufficient and convincing evidence to explain all of the developments of the disease. SLK may be associated with thyroid abnormalities, particularly hyperthyroidism, but is also found in individuals with normal thyroid function. [2] [3] In advanced cases, superior limbal stem cell deficiency syndrome may occur from the repeated microtrauma to the limbal stem cells. [5]
What is CLSLK eye?
A different condition, known as Contact Lens-Induced Superior Limbic Keratoconjunctivitis (CLSLK) is an eye inflammatory condition with an almost identical presentation, but it is related to contact lens wear. [6]
Is SLK a thyroid disorder?
SLK may be associated with thyroid abnormalities, particularly hyperthyroidism, but is also found in individuals with normal thyroid function. [2] [3] In advanced cases, superior limbal stem cell deficiency syndrome may occur from the repeated microtrauma to the limbal stem cells. [5]
What is the condition called when you have a limbic keratoconjunctivitis?
Almost 50% of the individuals with Superior Limbic Keratoconjunctivitis are said to suffer from another condition, called Dry Eye Syndrome (Keratoconjunctivitis sicca)
How is Superior Limbic Keratoconjunctivitis Diagnosed?
Diagnostic tests performed for Superior Limbic Keratoconjunctivitis are:
What are the Signs and Symptoms of Superior Limbic Keratoconjunctivitis?
The intensity of signs and symptoms may vary from time to time; and both eyes may be affected. Common presentations of Superior Limbic Keratoconjunctivitis are:
What is the name of the eye disorder that is characterized by repeated episodes of inflammation of the cornea and conjunc?
Superior Limbic Keratoconjunctivitis (SLK), also known as Theodore’s SLK, is an uncommon eye disorder that is characterized by repeated episodes (over many years) of inflammation of the cornea and conjunctiva (outer most membrane of the eyelid, in contact with the eyeball) It is understood that thyroid dysfunction leading to some sort ...
Why does keratoconjunctivitis occur?
They are thought to occur spontaneously, or due to certain morphological (anatomical) anomalies caused by abnormal thyroid function
What are the symptoms of a keratoconjunctivitis?
Common presentations of Superior Limbic Keratoconjunctivitis are: Eye pain and eyelid inflammation/thickening; with gritty feeling of sand-like particles inside the eye.
Why do my eyes tear?
Thyroid malfunction; hypothyroidism. Scarring of the conjunctiva, due to any disorder/infection. Any condition that causes reduced tearing from the eye for a prolonged period; like a chronic inflammation. Oxygen deprived eyelids causing tight-fitting eyelids, or closure of the eyes for long durations.
What is the treatment for keratoconjunctivitis sicca?
Treatment of underlying keratoconjunctivitis sicca with supplemental lubrication or punctal occlusion
What is the primary aetiological factor in the development of CLSLK?
The primary aetiological factor in the development of CLSLK is thimerosal hypersensitivity. Provocative tests in thimerosal-sensitized patients result in general conjunctival redness 1,3 (not just confined to the superior limbus), meaning that contact lens wear has impacted the clinical presentation. Therefore, other factors perhaps play a minor role by initiating, modulating or exacerbating this condition. Evidence relating to the significance of these aetiological factors will be considered in turn.
How to diagnose SLK?
The redundancy of the superior bulbar conjunctiva can be demonstrated by using a cotton-tipped applicator to pull the conjunctiva down over the superior cornea. This should be done after application of topical anesthesia and is not possible with normal conjunctiva. Impression cytology may give additional certainty to the diagnosis but is rarely necessary. With impression cytology, impressions of the superior bulbar conjunctiva demonstrate severe squamous metaplasia, with an absence of goblet cells. Impressions of the superior tarsal conjunctiva show mild squamous metaplasia with many inflammatory cells, while impressions of the inferior tarsal conjunctiva are essentially normal. 9
What are the variables of confocal microscopy?
Two variables that were studied were mean individual epithelial cell area (MIECA) and nucleocytoplasmic (N/C) ratio . As compared to normal controls, SLK patients were found to have a significantly increased MIECA and a decreased N/C ratio. Additionally, the inflammatory cell density in SLK patients was increased, compared to controls. This increase significantly correlated with superior bulbar conjunctival rose bengal scores, as measured by impression cytology, giving additional credence to confocal microscopy as a reliable diagnostic tool. 10
What is the condition where fine threads of mucin and corneal epithelium form?
Filamentary keratitis is a condition in which fine threads of mucin and corneal epithelium form. These remain attached at their base to the surrounding epithelium ( Fig. 26.5). Symptoms usually consist of foreign-body sensation and pain. It is associated with keratoconjunctivitis sicca, superior limbic keratoconjunctivitis and systemic disorders such as rheumatoid disease (Kowalik & Rakes 1991 ).
Is CLSLK a delayed reaction?
Mackie 13 argues that CLSLK can present as a Type I ( immediate) or Type IV (delayed) hypersensitivity reaction, primarily based upon clinical evidence that some patients display an immediate reaction and some display a delayed response.
Is CLSLK a contact lens condition?
In its mild form, contact-lens-induced superior limbic keratoconjunctivitis (CLSLK) is easy to overlook. The condition is confined to the superior limbal area and as such is hidden by the upper lid in primary gaze. The proper procedure for observing this condition is to lift the upper lid while the patient gazes down.
Why do people get conjunctivitis?
The majority of cases of conjunctivitis and keratoconjunctivitis are due to allergies. When it comes to infections, viruses are the most common among all age groups. Bacterial conjunctivitis is more common among children.
What is a phlyctenular keratoconjunctivitis?
Phlyctenular keratoconjunctivitis. Phlyctenular keratoconjunctivitis (PKC) is triggered by microbial antigens. That includes staphylococcus, tuberculosis, and chlamydia. One key symptom is the formation of nodules where the cornea meets the white of the eye. It can make you feel like there’s something in your eye.
What is the difference between keratoconjunctivitis and conjunctivitis?
Summary. Keratoconjunctivitis is when you have both keratitis and conjunctivitis at the same time. Keratitis is inflammation of the cornea, the clear dome that covers the iris and the pupil. Conjunctivitis is inflammation of the conjunctiva. That’s the thin membrane over the white part of the eye and the inner surface of the eyelid.
What is the name of the condition that causes a recurring eye inflammation?
Superior limbic keratoconjunctivitis (SLK) is a chronic, recurring eye inflammation. The cause is unknown. SLK is rare and affects women more often than men. Symptoms develop slowly over a span of 1 to 10 years before resolving.
What causes a person to lose the feeling in their eye?
Neurotrophic keratoconjunctivitis. Neurotrophic keratoconjunctivitis is a rare degenerative eye disease caused by nerve damage. It can cause you to lose feeling in your cornea, so you probably won’t have any pain. It can leave the cornea susceptible to injury.
What is the name of the condition where the eye is made up of water, fatty oils, and mucus?
Keratoconjunctivitis sicca is commonly known as dry eye syndrome. Tears are made up of water, fatty oils, and mucus. You need the right mixture of all three to properly nourish your eyes. Dry eye syndrome can happen from: an imbalance in the tear mixture. not producing enough tears.
What is EKC eye?
Epidemic keratoconjunctivitis (EKC) is an eye infection caused by human adenovirus. It’s also called viral keratoconjunctivitis or adenoviral keratoconjunctivitis.
Which eyelid is affected by vernal keratoconjunctivitis?
Unlike atopic keratoconjunctivitis, vernal keratoconjunctivitis affects the upper eyelid more than the lower.
When does keratoconjunctivitis occur?
This type of keratoconjunctivitis commonly occurs in children ages 6 months to 16 years. It is also found more often in girls than boys and tends to occur more frequently in the springtime.
What is a phlyctenular keratoconjunctivitis?
Phlyctenular keratoconjunctivitis is an inflammation of the cornea and conjunctiva. This type of keratoconjunctivitis is caused by an antigen. A common antigen is staphylococcus aureus bacteria (which causes staph infections). Another is mycobacterium tuberculosis (which causes tuberculosis).
What is SLK eye?
Superior limbic keratoconjunctivitis (SLK) is chronic and recurrent. SLK affects the following parts of the eye:
What is the medical term for dry eye syndrome?
Keratoconjunctivitis sicca (KCS), often referred to as dry eye syndrome
What is the name of the bump on the upper eyelid?
Vernal keratoconjunctivitis (VKC) is another type of allergic keratoconjunctivitis. VKC is associated with chronic and severe allergies. The condition causes notable features such as hard, cobblestone-like bumps located on the upper eyelid. These bumps may be accompanied by swelling or mucous discharge.
What causes dry eyes?
These conditions affect both the surface of the cornea and the conjunctiva. Underlying causes of keratoconjunctivitis can include bacteria, viruses, allergies, chemicals and even genetics.
How to tell if you have superior limbic keratoconjunctivitis?
Common symptoms and signs of this condition are as follows: Dryness in eye. Itching and burning sensation in eyes. Pain in eyes. Redness and inflammation of the upper eyelid. Gritty sensation as if sensation of sand in the eye.
What is the condition called when the eye is a recurrent inflammatory disease?
Superior limbic keratoconjunctivitis (SLK) is a chronic recurrent inflammatory disease of eye, mainly affecting the cornea and the conjunctiva. Although the exact etiology of this condition is not known, it has been associated with many other conditions such as hypothyroidism, Graves disease, rheumatoid arthritis, keratoconjunctivitis, etc. Frederick Theodore in 1963 was the first person to describe SLK in many patients suffering from inflammation of conjunctiva and cornea without obvious indication of infective pathology.
Why does SLK develop?
It is believed to develop with spontaneity or due to anatomical changes caused by thyroid disease. Continuous mechanical irritation caused by pressure of the upp er eyelid on the eye globe or increased motility of the bulbar part of conjunctiva may cause SLK.
Why do my eyes get dry?
Often rheumatoid arthritis, constant working on computer, etc can cause dryness in eyes. Closure of eye for long time can deprive oxygen to the eye. Certain eye surgeries that can cause change in the conjunctiva lining. Aging.
Is superior limbic keratoconjunctivitis a chronic recurrent condition?
Superior limbic keratoconjunctivitis is a chronic recurrent condition. There are many treatment modalities that can be used , but there is no specific treatment that can cure. It only helps to alleviate the symptoms .
Can you wear contact lenses for refractory error?
Avoid use of contact lens that are meant for refractory error. Instead patient must wear eye glasses.
Is limbic keratoconjunctivitis autoimmune?
Some people have proposed autoimmune theory as it is associated with thyroid disease, rheumatoid arthritis and Sogjren’s disease. Superior limbic keratoconjunctivitis can occur in anyone though it is more prevalent in females and middle aged individuals. Associated risk factors include:
