Medication Summary

Mast cell stabilizers and vitamin A preparations have been used with moderate success in the treatment of superior limbic keratoconjunctivitis (SLK). However, these approaches usually offer only temporary mitigation of symptoms, and more definitive treatments are often required. Preservative-free artificial tears may also be helpful.

Topical cyclosporine has been shown to provide symptom relief and to improve the signs of superior limbic keratoconjunctivitis; however, maintenance therapy is required for continued benefit.^[37]

Class Summary

Mast cell stabilizers inhibit type 1 immediate hypersensitivity reactions and are used for the long-term inhibition of inflammation.

Lodoxamide tromethamine 0.1% (Alomide)

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Lodoxamide is a mast cell stabilizer with reported efficacy in the treatment of superior limbic keratoconjunctivitis.

Cromolyn sodium, ophthalmic (Crolom, Opticrom)

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Cromolyn is another mast cell stabilizer with reported efficacy in the treatment of superior limbic keratoconjunctivitis.

Class Summary

Topical application of cauterizing agents is used for the treatment of keratinized conjunctivae.

Silver nitrate

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An application of silver nitrate to the anesthetized conjunctiva usually relieves symptoms of superior limbic keratoconjunctivitis for 4-6 weeks. Then, the treatment can be repeated safely.

Class Summary

Immunomodulatory agents modulate key factors of the immune system.

Cyclosporine A, 0.05% topical (Restasis)

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Cyclosporine A is used to relieve dry eyes caused by suppressed tear production secondary to ocular inflammation. This agent is thought to act as a partial immunomodulator, but its exact mechanism of action is not known.

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Author

Jean Deschênes, MD, FRCSC Professor, Research Associate, Director, Uveitis Program, Department of Ophthalmology, McGill University Faculty of Medicine; Senior Ophthalmologist, Clinical Director, Department of Ophthalmology, Royal Victoria Hospital, Canada

Jean Deschênes, MD, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, Canadian Medical Association, Canadian Ophthalmological Society, International Ocular Inflammation Society, Quebec Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Jia Yue You, MDCM Resident Physician, Department of Ophthalmology, McGill University Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University; Director of the Cornea Service, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: AAO; OMIC; American Society of Ophthalmic Trauma (ASOT); Avellino, Baxis; Bio-Tissue; Celularity; Dompe; Emmecell; Glaukos; Kala; Oyster Point; Sun Ophthalmics; Tarsus; TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Glaukos; Dompe; Bio-Tissue<br/>Received research grant from: Glaukos<br/>Received income in an amount equal to or greater than $250 from: AAO; OMIC; Baxis; Bio-Tissue; Cellularity; Dompe; Glaukos; Kala; Sun Ophthalmics; TearLab<br/>stock options for: RPS, Fount Bio.

Chief Editor

Hampton Roy, Sr, MD † Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

James H Oakman, Jr, MD Partner, Southern Eye Center, Augusta, Georgia

James H Oakman, Jr, MD is a member of the following medical societies: Association of American Physicians and Surgeons, Georgia Medical Society, Georgia Society of Ophthalmology, Georgia Society of the American College of Surgeons, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Susan Ruyu Qi University of Montreal Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Sections Superior Limbic Keratoconjunctivitis (SLK)
Overview
Presentation
DDx
Workup
Treatment
Medication
References

Superior Limbic Keratoconjunctivitis (SLK) Medication

Medication Summary

Mast Cell Stabilizers