Superior Limbic Keratoconjunctivitis (SLK)

Superior Limbic Keratoconjunctivitis (SLK)
		SYMPTOMS	Pain \| Burning \| Photophobia
		SIGNS	Superior bulbar conjunctival injection and thickening \| Tearing \| Superior corneal/limbal/conjunctival staining with NaFl
		WORK-UP	Thorough history and slit lamp exam with NaFl. Lift the upper eyelid and ask the patient to look down.
		TREATMENT
			TOPICAL: Preservative-free artificial tears \| steroids (Pred Forte 1% or Lotemax 1 gtt qid). Steroids should be tapered slowly to avoid rebound inflammation \| Consider long-term cyclosporine 0.05%
			Botox injections into the muscle of Riolan may help reduce friction
			In severe cases, surgery may be considered: Conjunctival resection \| Cautery \| Cryotherapy
		FOLLOW-UP	Every 2-4 weeks during treatment. Every 6 months for monitoring
		ADDITIONAL LAB \| TESTS	Thyroid function testing
		ETIOLOGY	Unknown \| SLK has been associated with thyroid dysfunction.
		DIFFERENTIAL DX	Episcleritis \| Scleritis \| Keratoconjunctivitis sicca \| Sjogren’s syndrome \| Viral conjunctivitis \| Floppy eyelid syndrome
NOTES	SLK can wax and wane and remain a chronic condition