Thygeson‘s superficial punctate keratopathy

Abstract

Thygeson‘s superficial punctate keratitis (TSPK) is a chronic disorder with episodes of exacerbations and remissions which span over years to decades. Typical features of the disease include multiple, grayish white, intraepithelial corneal lesions with minimal or no conjunctival involvement. The exact etiopathogenesis of this entity is unknown. However, it may have a genetic association with HLA-DR3, an antigen proved to be associated with immunogenic responses. Treatment of the disease consists of artificial tears, topical corticosteroids, topical cyclosporine, topical tacrolimus, or usage of soft contact lenses. TSPK should be considered as a diagnosis of exclusion in cases of bilateral superficial punctate keratopathy of long duration. Thirteen patients of TSPK were examined during the last 6 years (2014–2019) at our Institute. Visual acuity was 20/20 to 20/30 in majority cases. All patients required lubricants.

Isolated corneal involvement by Lichen Planus - multi-modal evaluation

“…During the inactive, chronic phase however, these granular lesions flatten, appearing as gray subepithelial opacities that stain negatively with fluorescein. 6 In contrast, our patient did not show such slightly raised typical white lesions. In fact, there were multiple punctate, fluorescein positive lesions with underlying anterior stroma edema.…”

West Indian Punctate Keratopathy and “Puerto Rican (PR) Spots”

“…Examination of Thygeson's superficial punctate keratopathy (TSPK) also reveals dots in the cornea [4,9,11,12]. However, TSPK primarily affects the corneal epithelium and tends to manifest with a range of symptoms, including photophobia, tearing, burning, and a foreign body sensation [13][14][15]. It is also important to consider non-infectious differential diagnoses such as scars in patients with a history of superficial corneal foreign bodies or ocular trauma.…”