Abstract
BackgroundThygeson’s superficial punctate keratitis (TSPK) is reportedly a rare disease with an insidious onset, numerous remissions and exacerbations, and a long duration. The corneal lesions are elevated, whitish–grey in colour, and granular in the intraepithelium. A few reported cases of TSPK exist, and paediatric experience is limited. Due to the unknown aetiology and controversial treatment strategies for TSPK, we performed a literature review to summarize the criteria for the diagnosis, treatment and prognosis of TSPK to provide a basis for the treatment of TSPK in paediatric patients.Case presentationThe clinical course of a boy with TSPK who repeatedly presented with episodes of tearing, photophobia and foreign body sensation in both eyes is described. Irritation was uncontrollable with antiviral and antibiotic medications, and it was managed by corticosteroids. No recurrence was reported at the 1-year follow-up after corticosteroid replacement and tapering.ConclusionsThe clinical features, treatment and prognosis between adult and paediatric TSPK patients have many similarities. The diagnosis of TSPK in children is more difficult, leading to missed diagnosis. TSPK needs to be carefully differentiated from other types of keratitis, especially intraepithelial secondary and other infectious ocular surface diseases.
Highlights
Thygeson’s superficial punctate keratitis (TSPK) is reportedly a rare disease with an insidious onset, numerous remissions and exacerbations, and a long duration
TSPK needs to be carefully differentiated from other types of keratitis, especially intraepithelial secondary and other infectious ocular surface diseases
We describe a paediatric case and performed a literature review to summarize the criteria for the diagnosis, treatment and prognosis of TSPK to provide a basis for the treatment of TSPK in paediatric patients
Summary
The diagnosis of TSPK is based on the clinical symptoms and signs. Ocular irritation, including a foreign body sensation and pain, is the most common symptom in patients with TSPK, followed by photophobia, blurred vision, and tearing, and TSPK is rarely accompanied by redness, dryness and discharge. The diagnosis of TSPK needs to be differentiated from bacterial and viral infections on the ocular surface. Secondary infections of Ethics approval and consent to participate This study complied with the tenets of the Declaration of Helsinki. Ethical approval was not required as this manuscript presents a case study. Consent for publication Parental consent was obtained from the patient’s parents for publication of the case report and accompanying images. Written informed consent for publication of the clinical details was obtained from the patient’s parents. Competing interests The authors have no conflicts of interest to disclose
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