Cases reported "Keratoconjunctivitis"

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1/6. Treatment of superior limbic keratoconjunctivitis by application of autologous serum.

    PURPOSE: To determine the efficacy of autologous serum drops in the treatment of superior limbic keratoconjunctivitis (SLK). methods: Twenty-two eyes of 11 patients were diagnosed with SLK. All eyes were treated with 20% diluted autologous serum eyedrops 10 times a day in addition to ongoing treatment of dry eye. fluorescein and rose bengal staining scores, as well as subjective symptom gradings, were performed before and after 4 weeks of therapy. RESULTS: Nine of the 11 patients responded well to treatment (82%). The average rose bengal and fluorescein score improved ( p < 0.05), and there was subjective improvement. CONCLUSION: Autologous serum application can be used as an alternative mode of therapy in SLK.
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2/6. Topical tacrolimus ointment for treatment of refractory anterior segment inflammatory disorders.

    PURPOSE: To report 4 cases of patients treated with topical tacrolimus ointment 0.03% for ocular inflammatory conditions refractory to traditional treatment. methods: Four patients were treated topically with tacrolimus 0.03% ointment twice daily: 2 patients with blepharokeratoconjunctivitis, 1 patient with severe atopic keratoconjunctivitis, and 1 patient with chronic follicular conjunctivitis. RESULTS: Three patients had a dramatic improvement of their ocular condition as early as 2 weeks after starting tacrolimus ointment. One patient developed a herpes simplex virus dendrite after 1 week of tacrolimus use. CONCLUSION: tacrolimus ointment appears to be an effective alternative for certain ocular inflammatory conditions refractory to traditional treatments. There may be an increased risk of herpes simplex virus keratitis associated with topical use. Our results support previous literature of patients benefiting from topical tacrolimus use.
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3/6. Treatment of superior limbic keratoconjunctivitis with topical cromolyn sodium.

    Eight patients with superior limbic keratoconjunctivitis (SLKC) were treated with topical cromolyn sodium. All standard modes of therapy had failed. Six patients manifested marked improvement or complete resolution of their condition. The administration of cromolyn sodium appears to be a safe and effective alternative in the treatment of SLKC.
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4/6. Treatment of superior limbic keratoconjunctivitis by thermocauterization of the superior bulbar conjunctiva.

    Superior limbic keratoconjunctivitis (SLK) is a chronic and recurrent inflammatory disease of the superior tarsal, bulbar and limbal conjunctiva that often responds to topical treatment with silver nitrate. As an alternative treatment in 11 patients (13 eyes), we applied thermal cautery to the inflamed superior bulbar conjunctiva following subconjunctival injection of 2% xylocaine. The overall positive response rate to thermocautery was 73% (8 patients). Of the positive responders, 63% (5 patients) had been considered silver nitrate treatment failures. keratitis sicca was additionally noted in 55% of the patients studied. Impression cytology of involved superior bulbar conjunctiva was nearly devoid of goblet cells during the acute stage of the disorder. Following successful cauterization, goblet cells returned. Thus, thermocauterization of the superior bulbar conjunctiva appears to be a safe and effective mode of therapy for SLK.
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5/6. Use of pressure patching and soft contact lenses in superior limbic keratoconjunctivitis.

    Eight patients with superior limbic keratoconjunctivitis (SLK) were successfully treated with the use of pressure patching and therapeutic soft contact lenses. In two patients, pressure patching alone was used to eliminate both the signs and symptoms of SLK. Therapeutic soft contact lenses were used after pressure patching in the other six patients to prevent recurrences of SLK. Our results suggest that eliminating the mechanical effect of the lid on the globe by pressure patching and then protecting the superior corneal limbus and adjacent bulbar conjunctiva by soft contact lenses may provide an alternative to silver nitrate applications in the treatment of SLK.
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6/6. Orally administered tetracycline for phlyctenular keratoconjunctivitis.

    We treated six patients who had recurrent episodes of nontuberculous phlyctenular keratoconjunctivitis and progressive corneal vascularization and scarring with oral tetracycline. This treatment resulted in rapid relief of symptoms and the apparent arrest of this disease. There have been no complications secondary to the use of tetracycline. To date, there has been only one recurrence in the patients treated with tetracycline which consisted of mild conjunctival hyperemia. We believe oral tetracycline is a safe and effective treatment for resistant and recurrent nontuberculous phlyctenular keratoconjunctivitis and an alternative to topical corticosteroid treatment in those patients suffering from corticosteroid-induced complications.
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