Editing Thygeson's superficial punctate keratopathy

{{Short description|Eye disease}}
{{Infobox medical condition (new)
| name            = Thygeson's superficial punctate keratopathy
| synonyms        = '''Thygeson Superficial Punctate Keratitis'''
| image           = Thygeson's keratitis left cornea after cyclosporin A treatment.jpg
| caption         = Full resolution of opacities. From Hasanreisoglu and Avisar, 2008.<ref name="pmid19105827">{{cite journal | vauthors = Hasanreisoglu M, Avisar R | title = Long-term topical cyclosporin A therapy in Thygeson's superficial punctate keratitis: a case report | journal = Cases Journal | volume = 1 | issue = 1 | pages = 415 | date = December 2008 | pmid = 19105827 | pmc = 2636787 | doi = 10.1186/1757-1626-1-415 | doi-access = free }}</ref>
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'''Thygeson's superficial punctate keratopathy''' ('''TSPK''') is a [[eye disease|disease of the eye]]s. 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 American [[Ophthalmology|ophthalmologist]] Phillips Thygeson (1903–2002), after whom it is named.<ref>{{cite journal | vauthors = Thygeson P | title = Superficial punctate keratitis | journal = Journal of the American Medical Association | volume = 144 | issue = 18 | pages = 1544–1549 | date = December 1950 | pmid = 14794375 | doi = 10.1001/jama.1950.02920180008004 }}</ref>

== Symptoms and signs==
A patient with TSPK may complain of blurred [[Visual perception|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 [[symptom]]s 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 not yet well known.<ref>{{cite journal | vauthors = Priyadarshini SR, Roy A, Das S | title = Thygeson's superficial punctate keratopathy: A review and case series | journal = Indian Journal of Ophthalmology | volume = 69 | issue = 4 | pages = 806–811 | date = April 2021 | pmid = 33727439 | pmc = 8012948 | doi = 10.4103/ijo.IJO_1624_20 | doi-access = free }}</ref>

==Diagnosis==
There are no proposed diagnostic criteria for TSPK, but its diagnostic features are "(1) the presence of bilateral punctate epithelial keratitis; (2) a chronic course with exacerbations and remissions; (3) healing without scar formation; (4) no response to antibiotics; and (5) a striking symptomatic response to topical corticosteroids."<ref>{{cite journal | vauthors = Tang XJ, Liu Q, Pi LH, Chen XK, Chen L | title = Thygeson's superficial punctate keratitis (TSPK): a paediatric case report and review of the literature | journal = BMC Ophthalmology | volume = 21 | issue = 1 | pages = 64 | date = January 2021 | pmid = 33514353 | pmc = 7845125 | doi = 10.1186/s12886-020-01790-6 | doi-access = free }}</ref>

== 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 (medicine)|remission]].{{cn|date=September 2022}}
* Artificial tear eye-drops or ointments may be a suitable treatment for mild cases.
* Low-dosage [[steroid]]al eye-drops, such as [[prednisone]], [[fluorometholone]], [[loteprednol]] (Lotemax 0.5%) or [[rimexolone]]. Steroidal drops should be used with caution<ref name="pmid10571306">{{cite journal | vauthors = Tanzer DJ, Smith RE | title = Superficial punctate keratitis of thygeson: the longest course on record? | journal = Cornea | volume = 18 | issue = 6 | pages = 729–730 | date = November 1999 | pmid = 10571306 | doi = 10.1097/00003226-199911000-00017 }}</ref> and the eye pressure should be regularly checked during treatment.
* Soft [[contact lens]]es.
* [[Ciclosporin]] is an experimental treatment for TSPK. It is usually used during [[Organ transplant|transplant]]s as it reduces the [[immune system]] response.
* [[Tacrolimus]] (Protopic 0.03% ointment) is also an experimental treatment.
* [[Laser eye surgery|Laser eye treatment]].<ref>{{cite journal | vauthors = Noble J, Boerman H, Jiang W, Martén L, McCormick GJ, Pepose JS, Solomon R, Yeu E | title = Peer-Reviewed Literature: The Treatment of Thygeson's Superficial Punctate Keratitis | date = June 2007 | journal = Cataract & Refractive Surgery Today | pages = 21–23 }}</ref>
* [[Amniotic membrane]] (Case Study)<ref>{{cite journal | vauthors = Kobayashi A, Yoshita T, Sugiyama K, Miyashita K, Niida Y, Koizumi S, Tseng SC | title = Amniotic membrane transplantation in acute phase of toxic epidermal necrolysis with severe corneal involvement | journal = Ophthalmology | volume = 113 | issue = 1 | pages = 126–132 | date = January 2006 | pmid = 16324747 | doi = 10.1016/j.ophtha.2005.09.001 }}<!--|access-date=9 December 2012--></ref>
* PRK laser eye surgery has been suggested in a one-person case study as having cured this disease.<ref>{{cite journal | vauthors = Goldstein MH, Feistmann JA, Bhatti MT | title = PRK-pTK as a treatment for a patient with Thygeson's superficial punctate keratopathy | journal = The CLAO Journal | volume = 28 | issue = 4 | pages = 172–173 | date = October 2002 | pmid = 12394540 | doi = 10.1097/01.ICL.0000024359.29208.59 | doi-broken-date = 1 November 2024 | s2cid = 23076934 }}</ref>

== References ==
{{reflist|30em}}

== External links ==
{{Medical resources
|  ICD10          = {{ICD10|H|16|1|h|15}}
|  ICD9           = {{ICD9|370.21}}
|  ICDO           =
|  OMIM           =
|  MedlinePlus    =
|  eMedicineSubj  = article
|  eMedicineTopic = 1197335
|  DiseasesDB     = 31288
}}

{{Eye pathology}}

{{DEFAULTSORT:Thygeson's Superficial Punctate Keratopathy}}
[[Category:Disorders of sclera and cornea]]