THYGESON'S SUPERFICIAL PUNCTATE KERATITIS a type of chronic, recurrent bilateral superficial punctate keratitis, which has got a specific clinical identity.
EtiologyExact etiology is not known.
- A viral origin has been suggested without any conclusion.
- An allergic or dyskeratotic nature also has been suggested owing to its response to steroids.
Clinical features
- Age and sex. It may involve all ages with no sex predilection.
- Laterality. Usually bilateral.
- Course. It is a chronic disease characterised by remissions and exacerbations.
It may be asymptomatic, but is usually associated with foreign body sensation, photophobia and lacrimation.
Signs
1. Conjunctiva is un inflamed (no conjunctivitis).
2. Corneal lesions. There are coarse punctate epithelial lesions (snow flake) circular, oval or stellate in shape, slightly elevated and situated in the central part (pupillary area) of cornea. Each lesion is a cluster of heterogeneous granular grey dots.
1. The disease is self-limiting with remissions and may permanently disappear in a period of 5-6 years.
2. During exacerbations the lesions and associated symptoms usually respond quickly to topical steroids (so, should be tapered rapidly).
3. Therapeutic soft contact lenses may be required in steroid-resistant cases.
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