Thygeson superficial punctate keratitis (TSPK) is a chronic, recurrent inflammatory condition of the corneal epithelium characterised by small, elevated, grey‑white lesions that cause irritation and photophobia.
Clinical Course
Episodes can last weeks to months and recur over years, often with periods of remission.
- Symptoms include foreign‑body sensation, tearing, light sensitivity, and mild blur; pain is usually moderate rather than severe.
- Lesions tend to be central, discrete, and stain poorly with fluorescein compared with other keratitides.
- Vision often improves between attacks, and permanent scarring is uncommon.
- The exact cause is unknown but likely immune‑mediated.
Management
Treatment focuses on symptom control and reducing inflammation.
- Lubricants provide comfort, while mild topical steroids or ciclosporin drops may be used for flare‑ups.
- Long‑term steroid use is avoided where possible because of cataract and glaucoma risk.
- Soft contact lenses can improve comfort in some patients but require careful supervision.
- Regular monitoring ensures that alternative causes of superficial keratitis are not missed.
