Cornea/Refractive Surgery Quiz 20

Yichieh Shiuey, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School

February 9, 1998
Figure 1
Figures 1-2. These are the anterior segment photographs of the right eye of a patient with recurrent episodes of foreign body sensation and tearing OU. The left eye has a similar appearance on slit lamp examination.
Figure 2
Questions and Answers
1. What is the diagnosis?
Answer: Thygeson's superficial punctate keratitis

2. What is the epidemiology of this condition?
Answer: All races and both sexes seem to affected with equal frequency. Onset typically occurs during the second and third decades of life.

3. What is the pathogenesis of the disease?
Answer: The exact pathogenesis is unclear. It has been hypothesized that a slow virus is responsible and that the lesions in Thygesons's SPK are a result of an inflammatory reaction to the virus.

4. What is the natural history of this conditon?
Answer: This condition has episodes of remission and exacerbations. Each attack typically last for several weeks and remissions last for 4-6 weeks. Most patients will eventually have complete resolution of symptoms over 2-4 years.

5. What is the management of this disorder?
Answer: Low dose topical steroids are effective in treating the signs and symptoms of Thygeson's SPK. However, steroids can prolong the duration of the disease. Alternatively, soft contact lenses may be used to relieve the symptoms, while the attack spontaneously resolves. There have also been anecdotal reports of success with topical antivirals, but results have been inconsistent.