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Etiology and management of vascularized limbal keratitis

1 May 2001


Background: Several literatures have been published on Vascular Limbal Keratitis but there is a lack of consensus on the etiology and standard of treatment. Through a literature review and a survey of contact lens diplomats, this study summarizes the most widely accepted etiology and treatment modalities for management of VLK.

Methods: 135 surveys were sent to currently practicing contact lens diplomats of the American Academy of Optometry based on the 1999 guidebook. 52 surveys were returned and evaluated. A literature review was done to supplement the results of the survey.

Results: The survey indicated that the most common possible etiologies of VLK are chronic peripheral desiccation (26.8 %), RGP lens design phenomena (24.6%), inadequate blink (16.8%) and tear film anomaly (15.1%). In early stage VLK, most practitioners chose to discontinue RGP wear temporarily, prescribe anti-inflammatory medications and refit with new or modified RGP lens parameters. For late stage VLK, the most common management responses were to discontinue RGP lens wear temporarily, prescribe anti-inflammatory medications and refit with soft contact lenses.

Conclusion: Vascularized Limbal Keratitis is a complication found in RGP lens wearers, but can be successfully treated. With early intervention and proper treatment modalities, the majority of VLK cases can be effectively managed with complete resolution.


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