Thygeson's superficial punctate keratopathy

Thygeson's Superficial Punctate Keratopathy (TSPK) is a rare, chronic eye disorder characterized by the presence of small, whitish-gray opacities or lesions on the cornea, which is the clear, dome-shaped surface that covers the front of the eye. First described by Phillips Thygeson in 1950, TSPK is considered a benign condition but can cause significant discomfort and visual disturbances. The exact cause of TSPK remains unknown, though it is thought to involve a combination of environmental, immunological, and genetic factors.

Symptoms

Patients with TSPK typically report a variety of symptoms, including:

• Eye irritation or foreign body sensation
• Tearing
• Photophobia (sensitivity to light)
• Blurred vision
• Mild to moderate eye pain

Symptoms can fluctuate in severity and may come and go over time, often with periods of remission and exacerbation.

Diagnosis

Diagnosis of TSPK is primarily based on clinical examination by an ophthalmologist. Key diagnostic features include the presence of characteristic punctate lesions on the cornea that are best visualized using slit-lamp biomicroscopy. These lesions are superficial and tend to be scattered across the central cornea. Unlike some other forms of keratitis, TSPK lesions do not typically stain with fluorescein, though they may stain with rose bengal or lissamine green.

Treatment

Treatment of TSPK is aimed at managing symptoms and may include:

• Artificial tears to help lubricate the eye and relieve discomfort
• Topical corticosteroids to reduce inflammation during acute flares
• Soft contact lenses to protect the cornea and improve comfort in some cases
• Antibiotic eye drops may be prescribed to prevent secondary bacterial infection, though they do not treat TSPK directly

The course of TSPK is unpredictable, and while some patients may experience resolution of symptoms, others may have recurrent episodes requiring ongoing management.

Epidemiology

The prevalence of TSPK is difficult to determine due to its rare nature and the variability of symptoms. It can occur at any age but is most commonly diagnosed in young adults and appears to affect men and women equally.

Prognosis

The prognosis for individuals with TSPK is generally good, with many patients achieving control of symptoms through treatment. However, the recurrent nature of the disease can lead to a decrease in quality of life due to ongoing discomfort and the need for continuous or repeated treatments.

See Also

• Keratitis
• Corneal ulcer
• Dry eye syndrome