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Superior limbic keratoconjunctivitis: Update on pathophysiology and management.

Dong-Ho Lee1, Mathew S Margolis2, Alfonso Iovieno1

  • 1Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, CanadaA.

The Ocular Surface
|April 3, 2023
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Summary

Superior limbic keratoconjunctivitis (SLK) involves inflammation of the eye

Keywords:
KeratoconjunctivitisSuperior limbic keratitisSuperior limbic keratoconjunctivitis

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Area of Science:

  • Ophthalmology
  • Corneal Science
  • Ocular Surface Disease

Background:

  • Superior limbic keratoconjunctivitis (SLK) is an under-recognized ocular surface disease.
  • Pathophysiology involves microtrauma and inflammation, often linked to tear film insufficiency.
  • This creates a self-perpetuating cycle driven by inflammatory cells and signaling.

Purpose of the Study:

  • To critically review the latest understanding of SLK pathophysiology.
  • To explore how this understanding informs current treatment strategies.
  • To highlight effective treatments targeting inflammation and mechanical stressors.

Main Methods:

  • Literature review of existing research on SLK.
  • Analysis of the interplay between microtrauma, inflammation, and tear film.
  • Discussion of therapeutic approaches based on pathophysiological insights.

Main Results:

  • SLK presents with characteristic superior conjunctival and limbal inflammation and staining.
  • Microtrauma and local inflammation, exacerbated by tear insufficiency, are key drivers.
  • Effective treatments address both inflammatory pathways and mechanical stressors.

Conclusions:

  • A deeper understanding of SLK pathophysiology guides more effective treatment.
  • Targeting inflammation and mitigating mechanical stressors are crucial for managing SLK.
  • Further research can refine therapeutic strategies for this condition.