Superficial punctate keratitis of Thygeson associated with scarring and Salzmann's nodular degeneration

A 59-year-old woman with superficial punctate keratitis of Thygeson was observed for 14 years. The patient was treated intermittently with topical corticosteroids and artificial tears. Immediate symptomatic relief was followed by multiple recurrences and exacerbations. This case was atypical because of its prolonged clinical course and development of permanent, subepithelial corneal scarring, and elevated lesions resembling Salzmann's nodular degeneration.