Often keywords need adjusting as the clinic changes, or as duplicates or spelling errors come about.
Click Metadata > Export Keywords from the top menu
Select a destination on the computer for the .txt file
Edit the text file for any adjustments you wish to make, save as a .txt file in the same place.
Importing : Pre-Toolbar
Go back to Lightroom and go Metadata > Import Keywords
Importing : Toolbar :
If you want to lock the keywords so no one can change them
File > Plug-in Manager
‘Use specific keyword list’ - select the file you just edited.