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Upper limbal keratoconjunctivitis
Last reviewed: 17.10.2021
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Upper limbal keratoconjunctivitis Theodore is a rare chronic inflammation that usually affects middle-aged women, possibly suffering from thyroid dysfunction. Upper limbal keratoconjunctivitis is often misdiagnosed, since subjective symptoms are more pronounced than objective symptoms. The condition is usually bilateral, although the manifestation may be asymmetric. The course is long, with periods of remission and exacerbations to a possible recovery.
Symptoms of upper limbal keratoconjunctivitis
The upper limbal keratoconjunctivitis is manifested by nonspecific signs: a foreign body sensation, burning sensation, photophobia and mucous discharge. Papillary hypertrophy of the conjunctiva of the upper eyelid, which can manifest as a diffusely velvety surface. Hyperemia of the upper tabloid conjunctiva, which is most intense near the limbus and decreases to the upper arch. Conjunctival epithelial cells can cornify, and the damaged area loses its shine. Point epithelial erosions in the upper part are common.
Upper filamentous keratitis occurs in approximately 1/3 of patients and is not necessarily associated with insufficiency of tear production. Dry keratoconjunctivitis - approximately 25% of cases.
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Treatment of upper limbal keratoconjunctivitis
It is aimed primarily at preventing the mechanical interaction between the upper eyelid and the upper limb. Specific treatment is not.
- Substitutes tears for dry eyes.
- Acetylcysteine 5% with filamentous keratitis.
- Occlusion of the upper lacrimal point is usually effective.
- Soft contact lenses, located between the eyelid and limb, are also effective.
- Cauterization of the upper tabloid conjunctiva is safe and often effective.