Contributor: Gordon K. Klintworth
Several different types of keratoconjunctivitis are recognized. They include keratoconjunctivitis sicca and superior limbic keratoconjunctivitis [keratoconjunctivitis - superior limbic]. Keratoconjunctivitis sicca is an extremely common disorder arising from decreased lacrimal fluid sectretion or increased tear film evaporation. It is predominantly a disorder of women. The causes include Sjögren syndrome. Symptoms, which include photophobia and a dry or foreign body sensation, are worse on arising and are accentuated by smoke exposure. Affected individuals may become more symptomatic and even worse with unnecessary antibiotic treatment. Individuals with certain types of  keratitis, such as staphylococcal keratitis [keratitis - staphylococcal] do not significantly benefit from treatment with artificial tears; therefore, it is important to differentiate these two entities that may have similar symptoms. Superior limbic keratoconjunctivitis presents as mild inflammation and vascular injection of the superior conjunctiva. Dead and dying cells on the ocular surface stain with Rose bengal. Filaments can be seen on the superior portion of the cornea. Bacterial keratoconjunctivitis [keratoconjunctivitis - bacterial] have been documented in patients with defective humoral immunity due to severe deficiencies of  B-lymphocytes.