Diagnosis and management of Thygeson's superficial punctate keratitis

Thygeson's superficial punctate keratitis (TSPK) is a chronic disease with exacerbations and remissions over years to decades. Hallmarks of the disease include multiple, whitish-gray, intraepithelial corneal lesions with minimal or no conjunctival involvement. Although its exact etiology is controversial, TSPK has a genetic association with HLA-DR3, an antigen associated with immunogenic responses. Treatment of the disease varies depending on severity and can consist of artificial tears, corticosteroids, topical cyclosporine, or soft contact lenses.

A 33-year-old African-American man presented with a complaint of a foreign body sensation in both eyes. After a thorough examination, a diagnosis of TSPK was made, and after appropriate management, complete resolution of the acute disease ensued.

A discussion of the case presented aims to provide clinicians with a clearer understanding of the clinical findings, etiology, and management of TSPK.