Daniella Lent-Schochet ¹ Mizna Akbar ¹ Joshua Hou ² Asim Farooq ^1*

• ¹ The University of Chicago, Chicago, United States
• ² University of Minnesota Health Sciences, University of Minnesota Medical Center, Minneapolis, Minnesota, United States

Limbal stem cell deficiency (LSCD) is an important cause of visual and ocular morbidity.Effective diagnosis and management require a thoughtful and comprehensive evaluation of the ocular surface. This review describes the pathogenesis, diagnosis, and grading of LSCD, as well as characteristic findings via slit lamp examination, in-vivo confocal microscopy, anterior segment optical coherence tomography (AS-OCT), impression cytology, and OCT angiography. 2.0 Introduction: Limbal stem cell deficiency (LSCD) is a disorder of the ocular surface where corneal epithelial homeostasis is disrupted by dysfunction or an insufficient quantity of limbal stem cells (LSCs). The past few decades have ushered in significant advancements in the detection and treatment of LSCD, and recently the lack of clear diagnostic standards was addressed by the Cornea Society's Limbal Stem Cell Working Group, which established a consensus amongst international experts on LSCD diagnosis and classification. 1 Accurate diagnosis and staging is critical for selecting the treatment that is best suited for a patient's disease severity. 2 Treatments can range from medical management alone to surgery. Kim, et al described cases of LSC dysfunction where medical therapy alone was sufficient to reverse signs of LSCD. 3 Corneal epithelial removal with or without amniotic membrane transplantation, conjunctival limbal autograft, conjunctival limbal allograft, keratolimbal allograft, cultivated limbal epithelial stem cells, simple limbal epithelial transplantation and