Association Between Thygeson Superficial Punctate Keratitis and Celiac Disease

Thygeson's superficial punctate keratitis (TSPK) is a rare, bilateral, chronic epithelial keratopathy characterized by recurrent exacerbations and remissions. Although its pathophysiology remains unclear, immunological and viral mechanisms have been implicated, with associations reported between TSPK and HLA-DR3. Similarly, celiac disease (CD) is an autoimmune disorder linked to HLA-DQ2 and HLA-DQ8, and HLA-DR3-DQ2. We report the case of a 20-year-old female with celiac disease who presented with TSPK. Clinical findings included stellate epithelial opacities and a pseudo-dendritic lesion, treated successfully with artificial tears, topical cyclosporine A, and therapeutic contact lenses. This case highlights a rare association between TSPK and CD, potentially explained by shared HLA genotypes, underscoring the need for further investigation into their immunogenetic link.