Contributor: Gordon K. Klintworth
Superior limbic keratoconjunctivitis is a chronic disease of the ocular surface characterized by recurrent episodes of inflammation involving the superior cornea, corneoscleral limbus as well as the the adjacent tarsal and bulbar conjunctiva. Although primarily bilateral, unilateral cases can occur. The condition presents as mild inflammation and vascular injection of the superior conjunctiva. The cause is unknown, but mechnical friction from tight upper eyelids or a loose redundant conjunctiva has been suspected. Adults (30-55 years old) are mainly affected. Dead and dying cells on the ocular surface stain with Rose bengal. Filaments can be seen on the superior portion of the cornea. Eventually the condition resolves after several years. The differential diagnosis includes several types of keratoconjunctivitis that occur with (keratoconjunctivitis sicca, neurotrophic keratitis [keratitis - neurotrophic], recurrent corneal erosion, trauma, bullous keratopathy [keratopathy - bullous], medicomentosa) or without corneal filaments (keratoconjunctivitis induced by contact lenses [contact lens - complications], phlyctenulosis, and Thygeson superficial punctate keratitis).