Presentation
Because of the chronic, remittent course of this disease, patients often present with their diagnosis "in hand." [web.archive.org]
A discussion of the case presented aims to provide clinicians with a clearer understanding of the clinical findings, etiology, and management of TSPK. [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]
Entire Body System
- Surgical Procedure
procedures and methods, including oculoplastic, corneal, and glaucoma surgery. [books.google.com]
Brain Cámara Anterior Conjuntiva Córnea Anatomía y Embriología Casos Post-Quirúrgicos and Surgical Procedures Degeneraciones Corneales Enfermedades Sistémicas (see also Systemic Diseases) Hereditary Distrofias Corneales Hereditatry Disgenesias Corneales [atlasophthalmology.net]
- Fatigue
Dry eyes cause discomfort, burning, stinging, eye fatigue, sensitivity to light, eye redness, a… In 1950, Phillips Thygeson published case reports on a superficial punctate keratitis (inflammation of the cornea) that he described as a condition involving [drshinblog.com]
Recurrences may be brought on by stress, fatigue, or ultraviolet light (UV) exposure (e.g., skiing or boating increase the exposure of the eye to sunlight; the sunlight reflects off of the surfaces). [dxline.info]
Blink speed can be affected by such as fatigue, eye injury, medication. The blinking rate is determined by the center, but it can also be affected by external stimulus. [wikivisually.com]
- Malaise
HZOProdrome – 2 to 3 days of malaise associated with fever, headache& hypoaesthesia with pain & burning in affecteddermatome Release of virus from sensory nerve ending – macularrash which becomes papular & then vesicular within24hrs New vesicles continue [slideshare.net]
Skin
- Pruritus
[…] metamorphopsia, vitreous adhesions*, conjunctival oedema, eyelid oedema, vitritis, anterior chamber cell, anterior chamber flare, iritis, photopsia, conjunctival hyperaemia, ocular hyperaemia, vitreous detachment, foreign body sensation in eyes, eye pruritus [tr-ex.me]
Ocular symptoms may include dry or red eyes, foreign-body sensation, pruritus, photophobia, pain, visual changes, and even complete loss of vision. [aafp.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]
- Snow Blindness
blindness Welders keratitis H16.131 Photokeratitis, right eye H16.132 Photokeratitis, left eye H16.133 Photokeratitis, bilateral H16.139 Photokeratitis, unspecified eye H16.14 Punctate keratitis H16.141 Punctate keratitis, right eye H16.142 Punctate [icd10coded.com]
Ultraviolet light from sunlight (snow blindness), a tanning light or a welder's arc, contact-lens overwear, and chemical agents, either in liquid form splashed into the eye or in gases in the form of fumes can all result in noninfectious keratitis. [medicinenet.com]
Neurologic
- Headache
Patients have lacrimation, pain, redness, swollen eyelids, photophobia, headache, foreign body sensation, and decreased vision. Permanent vision loss is very rare. [msdmanuals.com]
HZOProdrome – 2 to 3 days of malaise associated with fever, headache& hypoaesthesia with pain & burning in affecteddermatome Release of virus from sensory nerve ending – macularrash which becomes papular & then vesicular within24hrs New vesicles continue [slideshare.net]
Giant Cell Arteritis Up to 50 percent of patients with giant cell arteritis present with ocular symptoms that include pain, diplopia, visual loss, and amaurosis fugax, in addition to headache, jaw claudication, and neck pain. 21, 22 It is important to [aafp.org]
Workup
Microbiology
- Chlamydia
Two cases of follicular conjunctivitis due to Chlamydia trachomatis followed by punctate epithelial keratitis are described. Both cases were initially treated with either oral tetracycline or doxycycline with resolution of the follicles. [ncbi.nlm.nih.gov]
Studies have implicated a varicella virus, possibly herpes zoster, as well as Chlamydia trachomatis in the development of Thygeson's, although these claims are unsubstantiated. In most cases, Thygeson's SPK presents with insidious onset. [web.archive.org]
Etiologies include congenital or acquired syphilis, herpetic disease, Lyme disease, chlamydia, Wegener's granulomatosis, polyarteritis nodosa, rheumatoid arthritis, relapsing polychondritis, sarcoidosis, tuberculosis, Cogan syndrome, Acanthamoeba, leprosy [clspectrum.com]
— Human serology in chlamydia trachomatis infection with microimmunofluorescence. J. Infect. Dis., 130, 388, 1974. [link.springer.com]
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]
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]
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]
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]
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 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]
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]
[…] 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
Preventing viral outbreaks Some forms of viral keratitis can't be completely eliminated. [mayoclinic.org]
Long-term maintenance therapy with cyclosporine may prevent recurrence of corneal ulcers. Contact [aibolita.com]
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]