Thygeson's superficial punctate keratopathy

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Thygeson's superficial punctate keratopathy
Other namesThygeson Superficial Punctate Keratitis
Thygeson's keratitis left cornea after cyclosporin A treatment.jpg
Full resolution of opacities. From Hasanreisoglu and Avisar, 2008. [1]
Specialty Ophthalmology   OOjs UI icon edit-ltr-progressive.svg

Thygeson's superficial punctate keratopathy (TSPK) is a disease of the eyes. The causes of TSPK are not currently known, but details of the disease were first published in the Journal of the American Medical Association in 1950 by renowned American ophthalmologist Phillips Thygeson (19032002), after whom it is named. [2]

Contents

Symptoms

A patient with TSPK may complain of blurred vision, dry eyes, a sensation of having a foreign body stuck in the eye, photophobia (sensitivity to bright light), burning sensations and watery eyes. On inspection with a slit lamp, tiny lumps can be found on the cornea of the eye. These lumps can be more easily seen after applying fluorescein or rose Bengal dye eye-drops. The lumps appear to be randomly positioned on the cornea and they may appear and disappear over a period of time (with or without treatment).

TSPK may affect one or both eyes. When both eyes are affected, the tiny lumps found on the cornea may differ in number between eyes. The severity of the symptoms often vary during the course of the disease. The disease may appear to go into remission, only to later reappear after months or years.

Causes

The causes of TSPK are currently not yet well known. However, there seem to be indications that dysfunctioning of the Meibomian gland can cause the condition. Inflammation of the meibomian glands (also known as meibomitis, meibomian gland dysfunction, or posterior blepharitis) causes the glands to be obstructed by thick waxy secretions. Besides leading to dry eyes, the obstructions can be degraded by bacterial lipases, resulting in the formation of free fatty acids, which irritate the eyes and sometimes cause punctate keratopathy.

Treatment

There are a number of different treatments to deal with TSPK. Symptoms may disappear if untreated, but treatment may decrease both the healing time and the chances of remission.


Related Research Articles

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Blepharitis

Blepharitis is one of the most common ocular conditions characterized by inflammation, scaling, reddening, and crusting of the eyelid. This condition may also cause burning, itching, or a grainy sensation when introducing foreign objects or substances to the eye. Although blepharitis is not sight-threatening, it can lead to permanent alterations of the eyelid margin. The overall etiology is a result of bacteria and inflammation from congested meibomian oil glands at the base of each eyelash. Other conditions may give rise to blepharitis, whether they be infectious or noninfectious, including, but not limited to, bacterial infections or allergies.

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Chalazion

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References

  1. Hasanreisoglu M, Avisar R (2008). "Long-term topical cyclosporin A therapy in Thygeson's superficial punctate keratitis: a case report". Cases J . 1 (1): 415. doi:10.1186/1757-1626-1-415. PMC   2636787 . PMID   19105827.
  2. Thygeson P (December 1950). "Superficial punctate keratitis". J Am Med Assoc. 144 (18): 1544–9. doi:10.1001/jama.1950.02920180008004. PMID   14794375.
  3. Tanzer DJ, Smith RE (1999). "Superficial punctate keratitis of thygeson: the longest course on record?". Cornea. 18 (6): 729–30. doi:10.1097/00003226-199911000-00017. PMID   10571306.
  4. Noble, Jason; Boerman, Helen; Jiang, Wei; Martén, Lisa; McCormick, Gregory J.; Pepose, Jay S.; Solomon, Renée; Yeu, Elizabeth; Peer-Reviewed Literature: The Treatment of Thygeson’s Superficial Punctate Keratitis, June 2007, Cataract & Refractive Surgery Today, pp. 21-23
  5. Kobayashi, Akira; Yoshita, Tsuyoshi; Sugiyama, Kazuhisa; Miyashita, Kengo; Niida, Yo; Koizumi, Shoichi; Tseng, Scheffer C.G. (January 2006). "Amniotic Membrane Transplantation in Acute Phase of Toxic Epidermal Necrolysis with Severe Corneal Involvement". Ophthalmology. 113 (1): 126–132. doi:10.1016/j.ophtha.2005.09.001. PMID   16324747.
  6. Goldstein, Michael H.; Feistmann, Jonathan A.; Bhatti, M. Tariq (October 2002). "PRK-pTK as a treatment for a patient with Thygeson's superficial punctate keratopathy". The CLAO Journal. 28 (4): 172–173. doi:10.1097/01.ICL.0000024359.29208.59 (inactive 2021-01-15). ISSN   0733-8902. PMID   12394540.CS1 maint: DOI inactive as of January 2021 (link)
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