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2.1
Punctate Keratitis
Punctate Epithelial Keratoconj

Images

WIKIDATA, CC BY 2.0

Presentation

Because of the chronic, remittent course of this disease, patients often present with their diagnosis "in hand." [web.archive.org]

RESULTS: At the time of presentation, the mean patient age was 28.7 years. The most common presenting symptoms included photophobia, blurred vision, and irritation. [ncbi.nlm.nih.gov]

Case presentation A 15-year-old boy presented with long-term ocular symptoms of foreign body sensation, burning, irritation, tearing, and transient photophobia. One year's treatment with steroidal agents had led to only partial improvement. [doi.org]

Eyes

  • Foreign Body Sensation

    A 15-year-old boy presented with long-term ocular symptoms of foreign body sensation, burning, irritation, tearing, and transient photophobia. One year's treatment with steroidal agents had led to only partial improvement. [ncbi.nlm.nih.gov]

    Patients have lacrimation, pain, redness, swollen eyelids, photophobia, headache, foreign body sensation, and decreased vision. Permanent vision loss is very rare. [msdmanuals.com]

    Case presentation A 15-year-old boy presented with long-term ocular symptoms of foreign body sensation, burning, irritation, tearing, and transient photophobia. One year's treatment with steroidal agents had led to only partial improvement. [doi.org]

  • Corneal Opacity

    We observed the dissolution of honeycomb-like corneal opacities in a patient with confirmed Thiel-Behnke corneal dystrophy after the patient subsequently contracted chronic Thygeson superficial punctate keratitis. [ncbi.nlm.nih.gov]

    Clinically it appears as multiple, punctate or circular, gray, superficial corneal opacities that may or may not be ulcerated (Figure 11.22 ). The condition is bilateral and lesions are frequently symmetric. [aibolita.com]

    Keywords Topical Corticosteroid Topical Steroid Keratoconjunctivitis Corneal Edema Foreign Body Sensation Introduction In 1950, Thygeson was the first to describe the clinical entity of transient, bilateral, coarse corneal epithelial opacities, without [doi.org]

    The most common causes of loss of corneal transparency are: Corneal Oedema Drying of Cornea Depositions on Cornea Inflammations of Cornea Corneal Degenerations Dystrophies of cornea Vascularization of cornea Scarring of Cornea Corneal Opacities [ edit [en.wikibooks.org]

  • Conjunctival Injection

    There was only trace conjunctival injection. On slit-lamp examination, discrete, centrally located, slightly elevated, grayish-white corneal subepithelial opacities were detected, with a granular texture bilaterally (Figure 1 ). [doi.org]

    Upon gross inspection, the affected eye appears normal, with little or no evidence of eyelid swelling, conjunctival injection or corneal edema. [web.archive.org]

    Examination revealed severe conjunctival injection as well as punctate stains on the corneas. [avehjournal.org]

    Slitlamp examination found improvement in the superficial punctate keratitis and conjunctival injection (Figures 8 and 9). The papillary conjunctivitis and corneal infiltrate appeared unchanged. [siliconehydrogels.org]

    Diagnosis Symptoms: Ocular irritation, burning, itching, pain, foreign-body sensation, photophobia, and blurred vision Examination: Conjunctival injection/inflammation, decreased tear meniscus, decreased tear break-up time, increased debris in the tear [biotissue.com]

  • Conjunctival Hyperemia

    SPK in 5 corneal regions, conjunctival hyperemia, tear breakup time (TBUT), and intraocular pressure (IOP) were examined in a masked manner at baseline, 1 month, and 3 months. [ncbi.nlm.nih.gov]

    In phase 3 clinical trials of 0.05% and 0.1% ophthalmic emulsions of cyclosporin for the treatment of dry eye disease, the most common treatment-related adverse events were burning eye, stinging eye, and conjunctival hyperemia. [doi.org]

  • Burning Eyes

    In phase 3 clinical trials of 0.05% and 0.1% ophthalmic emulsions of cyclosporin for the treatment of dry eye disease, the most common treatment-related adverse events were burning eye, stinging eye, and conjunctival hyperemia. [doi.org]

Psychiatrical

  • Suggestibility

    The recurrence of lesions only in the peripheral untreated cornea suggests that the inflammatory signal in Thygeson's keratitis may reside in the superficial corneal stroma. [ncbi.nlm.nih.gov]

    Shirmer test without anesthesia was normal in both eyes, suggesting a normal tear production. The corneal sensibility was reduced when compared with the sensibility of the right cornea. [academic.oup.com]

Workup

HLA Type

  • HLA-DR3

    Although its exact etiology is controversial, TSPK has a genetic association with HLA-DR3, an antigen associated with immunogenic responses. [ncbi.nlm.nih.gov]

    Although TSPK has a genetic association with HLA-DR3, controversy exists regarding its exact etiology. [emedicine.medscape.com]

    Br J Ophthalmol. 2007;91(8):1038-41. ↑ 7.0 7.1 7.2 Darrell RW: Thygeson's superficial punctate keratitis: natural history and association with HLA-DR3, Trans Am Ophthalmol Soc 79:486, 1981. ↑ 8.0 8.1 8. [eyewiki.aao.org]

    […] is suggested by the presence of white blood cells in the conjunctiva and corneal epithelium, "by the extended course of the disease, by the therapeutic efficacy of topical corticosteroids," and by the presence in some individuals of an antigen called HLA-DR3 [webeye.ophth.uiowa.edu]

Prognosis

Cases of TSPK in patients ranging in age from 2.5 years to 70 years have been reported, with a mean age of 29 years. [2] Prognosis Regardless of the treatment method selected, the visual prognosis in patients with TSPK is excellent. [2, 3, 4] Patient [emedicine.medscape.com]

Outcome/Prognosis The visual outcome of TSPK is generally good, although some individuals have experienced slightly reduced visual acuity. Bibliography Gock G, Ong K, McClellan K. A classical case of Thygeson's superficial punctate keratitis. [webeye.ophth.uiowa.edu]

Treatments vary based on stage of disease/degree of ulceration if infectious keratitis develops Prognosis and Future Directions Crack eye syndrome is multifactorial in etiology Results in extensive and chronic corneal changes Repeated corneal trauma and [eyewiki.org]

Prognosis Most problems caused by CLs will make a full recovery following removal of the lens. Neovascularisation and microbial keratitis can cause permanent visual impairment if not treated quickly and adequately. [patient.info]

Etiology

Although its exact etiology is controversial, TSPK has a genetic association with HLA-DR3, an antigen associated with immunogenic responses. [ncbi.nlm.nih.gov]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

These corneal defects from crack cocaine were first described in 1989, and you need to consider the condition in corneal disease with no other etiology. [clspectrum.com]

Epidemiology

Marquezan MC, Nascimento H, Vieira LA, Serapião M, Ghanem RC, Belfort R, Freitas D Virological and epidemiological analysis of coxsackievirus A24 variant epidemic of acute hemorrhagic conjunctivitis in Okinawa, Japan, in 2011. [medicbind.com]

— Pharyngoconjunctival fever, epidemiological studies of a recently recognized disease entity. J.A.M.A., 157, 1083, 1955. [link.springer.com]

Epidemiology Frequency United States The frequency of TSPK in the United States is currently unknown. International The worldwide frequency of TSPK is unknown. [emedicine.medscape.com]

Corneal lesions show a tendency for the central pupillary area distribution with mild or absent conjunctival inflammation and no association to systemic disease. [1] [2] There are no specific data on the epidemiology of the disease. [eyewiki.aao.org]

Pathophysiology

Pathophysiology A review of the literature suggests the pathophysiology of TSPK remains unclear, although viral and immunogenic components are both likely in the disease's formation. [emedicine.medscape.com]

PATHOPHYSIOLOGY The etiology of Thygeson's SPK is unknown. Research indicates, however, that the condition may be caused by a chronic subclinical viral infection affecting the deeper layers of the corneal basal epithelium. [web.archive.org]

[…] scan OU Retina flat, no detachments, no masses OU Crack eye syndrome characterized by: Epitheliopathy/epithelial trauma Superficial punctate keratitis Epithelial defects Microbial keratitis Stromal melt and corneal perforation Neurotrophic keratopathy Pathophysiology [eyewiki.org]

The pathophysiology of TSPK remains unknown. Both, viral and immunologic mechanisms have been implicated. Adenovirus, herpes simplex virus, and varicella zoster virus, have all been implicated as a possible causes of the disease. [eyewiki.aao.org]

Prevention

Long-term maintenance therapy with cyclosporine may prevent recurrence of corneal ulcers. Contact [aibolita.com]

Preventing viral outbreaks Some forms of viral keratitis can't be completely eliminated. [mayoclinic.org]

Dark glasses or welder’s helmets that block UV light are preventive. Click here for Patient Education NOTE: This is the Professional Version. [msdmanuals.com]

Dark glasses or welder’s helmets that block UV light are preventive. [merckmanuals.com]

[…] and conditions: • Injuries due to arc welding overuse of lamps • Exposure to chemicals • Reactions to drugs prescribed for unrelated disorders • Immune or allergic reaction Treatment Eye drops used to act as artificial tears help lubricate the eye and prevent [optometrist.com.au]

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