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Superior Limbic Keratoconjunctivitis (SLK)
Î Mild cases of SLK may respond to treatment of concomitant dry eye
syndrome with lubricants. (III, I, D)
Î Mild cases of SLK may respond to treatment of concomitant dry eye
syndrome with mast-cell stabilizers. (III, I, D)
Î Mild cases of SLK may respond to treatment of concomitant dry eye
syndrome with cyclosporine. (III, I, D)
Î Mild cases of SLK may respond to treatment of concomitant dry eye
syndrome with soft contact lenses. (III, I, D)
Î Mild cases of SLK may respond to treatment of concomitant dry eye
syndrome with punctal occlusion. (III, I, D)
Î Associated filamentary keratitis may occasionally respond to topical
10% acetylcysteine. (III, I, D)
Î Persistent symptoms may necessitate surgical intervention such as
cautery (chemical or thermal) to tighten redundant conjunctiva or
conjunctival resection. (III, I, D)
Î An underlying thyroid disorder should be investigated by means of
thyroid function tests. (III, I, D)
Î Because SLK may persist with exacerbations over a period of years,
treatment and frequency of follow-up are driven by the patient's
symptoms. (III, I, D)
Î Patients should be informed that this is a chronic and recurrent
condition that rarely can decrease vision. (III, I, D)
Contact-Lens-Related Keratoconjunctivitis
Î In cases of contact-lens-related keratoconjunctivitis, contact lens
wear should be discontinued for ≥2 weeks until the cornea returns to
normal. (III, I, D)
Î A brief (1–2 weeks) course of topical corticosteroids may be
prescribed, in addition to more long-term topical cyclosporine 0.05%.
(III, I, D)
Î At the follow-up evaluation, the contact lens fit, type, and lens-care
regimen should be reviewed. (III, I, D)
Î At the follow-up evaluation, consideration should be given to
alternatives to contact lenses once the keratoconjunctivitis has
resolved. (III, I, D)
