Abstract: Thygeson’s Superficial Punctate Keratopathy (TSPK) is a rare but distinct form of superficial keratitis characterized by recurrent episodes of punctate epithelial lesions on the cornea. This article provides an in-depth analysis of TSPK, covering its clinical features, diagnostic criteria, differential diagnosis, and therapeutic approaches. By enhancing our understanding of TSPK, clinicians can effectively diagnose and manage this condition, thus improving patient outcomes and quality of life.

Introduction: Thygeson’s Superficial Punctate Keratopathy (TSPK) represents a unique entity within the spectrum of ocular surface disorders, characterized by its characteristic clinical presentation and chronic, relapsing course. While relatively uncommon, TSPK can significantly impact visual function and patient comfort, necessitating accurate diagnosis and tailored management strategies.

Clinical Features: TSPK typically manifests as discrete, gray-white, round or oval-shaped epithelial lesions distributed throughout the cornea. Patients may experience symptoms of ocular discomfort, foreign body sensation, and mild photophobia, often with intermittent exacerbations and remissions. Despite its chronic nature, TSPK is typically self-limiting, with episodes lasting several weeks to months before spontaneously resolving.

Diagnostic Criteria: Diagnosing TSPK relies primarily on clinical examination findings, including the presence of characteristic punctate epithelial lesions and the absence of significant corneal inflammation or other ocular pathology. Differential diagnosis may include other forms of superficial keratitis, such as viral or bacterial keratitis, as well as autoimmune conditions such as Sjögren’s syndrome or dry eye disease.

Differential Diagnosis: Distinguishing TSPK from other causes of superficial keratitis is essential to guide appropriate management. Clinical features such as the absence of corneal neovascularization, minimal or absent conjunctival injection, and lack of associated systemic symptoms can help differentiate TSPK from infectious or inflammatory etiologies.

Therapeutic Approaches: Management of TSPK focuses on alleviating symptoms and promoting epithelial healing during acute exacerbations. Treatment modalities may include lubricating eye drops, topical corticosteroids, and therapeutic contact lenses to minimize discomfort and enhance epithelial repair. In refractory cases, adjunctive therapies such as bandage contact lenses or amniotic membrane transplantation may be considered to facilitate corneal healing and mitigate recurrence.

Conclusion: Thygeson’s Superficial Punctate Keratopathy (TSPK) presents a unique diagnostic and therapeutic challenge in ophthalmic practice. By recognizing its characteristic clinical features, clinicians can establish a timely diagnosis and implement targeted management strategies to optimize patient outcomes. Continued research into the pathogenesis of TSPK and the development of novel therapeutic interventions hold promise for further enhancing our ability to manage this intriguing ocular condition.