Extensive superior limbic keratoconjunctivitis in Graves’ disease: case report and mini-review of the literature

Abstract

Elias Chelala, Hala El Rami, Ali Dirani, Henry Fakhoury, Ali Fadlallah Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon Background: Superior limbic keratoconjunctivitis (SLK) is characterized as an inflammation of the superior bulbar conjunctiva with predominant involvement of the superior limbus and adjacent epithelial keratitis.Methods: A 51-year-old woman, with a history of medically controlled Graves’ disease was seen with an extensive SLK involving 5 mm of the superior cornea.Results: Total remission was observed with topical steroids (DXM). Recurrence was observed 1 week after steroid discontinuation, and steroidal treatment was reintroduced with tapering over 1 month. Total remission was then observed for 1 year. Conclusion: Extensive keratitis and vascular pannus in SLK is rarely reported. This form could be treated with topical steroids. Tapering treatment remains essential for long-term success. Keywords: superior limbic keratoconjunctivitis, anti-inflammatory drugs, dexamethasone, triamcinolone, Graves’ disease