|Thygeson's Superficial Punctate
Biomicroscopy reveals numerous round or stellate areas of coarse, gray, slightly elevated intraepithelial opacities. These lesions resemble subepithelial infiltrates, but are more superficial, duller in color, and less organized. Also, these areas may demonstrate variable central staining with sodium fluorescein, whereas subepithelial infiltrates typically do not stain. Inspection of the anterior chamber shows neither cells nor flare.
Visual acuity may be normal or mildly reduced, depending upon the
density and location of the opacities. Because Thygeson's SPK tends to run a chronic,
remittent course, the patient may report similar experiences in the past. The clinical
presentation, although bilateral in nature, may be asymmetric, or involve only one eye at
In most cases, Thygeson's SPK presents with insidious onset. With or
without treatment, the lesions will eventually resolve; however, the disease often
continues to plague these patients for months or even years, with sporadic exacerbations.
The trigger mechanism for these flare-ups appears to be idiopathic.
Treat more severe presentations with topical steroids, such as 0.1%
fluorometholone alcohol (FML) or 1% rimexolone (Vexol). In most cases, QID dosing is
adequate, but increase dosage in severe cases if necessary. Continue the treatment for one
week, and then slowly taper therapy to avoid a rebound inflammation. Follow up weekly
during therapy, then every three to 12 months during remission.
Other reports in this section
Eyelids & Eyelashes | Conjunctiva & Sclera | Cornea
Uvea | Vitreous & Retina | Optic Nerve & Brain | Oculosystemic Disease
Handbook Main Page