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Thygeson's superficial punctate keratopathy

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Title: Thygeson's superficial punctate keratopathy  
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Thygeson's superficial punctate keratopathy

Thygeson's superficial punctate keratopathy
Full resolution of opacities. From Hasanreisoglu and Avisar, 2008.[1]
Classification and external resources
ICD-10 H16.1
ICD-9-CM 370.21
DiseasesDB 31288
eMedicine article/1197335

Thygeson's superficial punctate keratopathy (TSPK; also Thygeson Superficial Punctate Keratitis) 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 Phillips Thygeson - after whom it is named.[2]

Contents

  • Symptoms 1
  • Causes 2
  • Treatment 3
  • See also 4
  • References 5
  • External links 6

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 glands 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.

  • PRK laser eye surgery may cure this disease (NOTE: A full clinical study has not been done, but a case study of one person was reported in 2002 PRK-pTK as a treatment).
  • Artificial tear eye-drops or ointments may be a suitable treatment for mild cases.
  • Low-dosage steroidal eye-drops, such as prednisone, fluorometholone, loteprednol (Lotemax 0.5%) or rimexolone. Steroidal drops should be used with caution[3] and the eye pressure should be regularly checked during treatment.
  • Soft contact lenses.
  • transplants as it reduces the immune system response.
  • Tacrolimus (Protopic 0.03% ointment) is also an experimental treatment.
  • Laser eye treatment.[4]
  • Amniotic membrane (Case Study)[5]

See also

[6]

References

  1. ^ Hasanreisoglu M, Avisar R (2008). "Long-term topical cyclosporin A therapy in Thygeson's superficial punctate keratitis: a case report".  
  2. ^ Thygeson P. Superficial punctate keratitis. J Am Med Assoc 1950;144:1544-9. PMID 14794375.
  3. ^ Tanzer DJ, Smith RE (1999). "Superficial punctate keratitis of thygeson: the longest course on record?". Cornea 18 (6): 729–30.  
  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.  
  6. ^ Thygeson's superficial punctate keratopathy.(CORNEA)(Disease/Disorder overview); Review of Optometry ISSN: 1930-160X Date: 04/15/2010 Volume: 147 Issue: 4 Page(s) 26A-27A

External links

  • Handbook of Ocular Disease Management TSPK page
  • UIHC Ophthalmology and Visual Sciences TSPK page
  • TSPK treatments
  • Discussion Group Registration for the Discussion Group
  • Discussion forum. NEW
  • Information on Thygesons SPK and Discussion forum. NEW
  • https://www.facebook.com/groups/tspksupport/
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