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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 | |
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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 |
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]
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]
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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]
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]
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