Superior limbic keratoconjunctivitis. A prognostic sign for severe Graves ophthalmopathy

To study superior limbic keratoconjunctivitis in a relatively large group of patients and to determine whether a relation exists with thyroid dysfunction.

The medical records of 57 patients with superior limbic keratoconjunctivitis who were examined between 1980 and 1993 were reviewed.

Thirty-seven patients (64.9%; 95% confidence interval, 51.1-77.1) had objective evidence of thyroid dysfunction. Of patients with superior limbic keratoconjunctivitis and thyroid disease, 33 (89.2%) had ophthalmopathy, which in 16 patients (48.5%) was sufficiently severe to require orbital decompression.

Superior limbic keratoconjunctivitis is associated with thyroid dysfunction and appears to be a prognostic marker for severe Graves ophthalmopathy.