Galaxy of Dots - SPKs
𝐒𝐮𝐩𝐞𝐫𝐟𝐢𝐜𝐢𝐚𝐥 𝐩𝐮𝐧𝐜𝐭𝐚𝐭𝐞 𝐊𝐞𝐫𝐚𝐭𝐢𝐭𝐢𝐬
Multiple, small discrete lesions of the cornea - Affect epithelial and subepithelial layers
𝐂𝐚𝐮𝐬𝐞𝐬 based on distribution of lesions in the cornea:
● Generalized - Acute conjunctivitis, Toxic conjunctivitis, Vernal conjunctivitis
● Central- Adenoviral conjunctivitis, Thygeson’s, CL overwear
● Upper 1⁄3 - Inclusion Conjunctivitis, Superior limbic Keratoconjunctivitis
● Lower 1⁄3 - Staphylococcus disease, Exposure keratitis, Entropion
● Lower 2⁄3- Dry eye, Exposure keratitis, Neurotrophic keratitis
● Zonular- Herpes
● Paralimbal- Adjacent to pterygium/ any other conjunctival lesion
● Linear streak- Tarsal foreign body
𝐓𝐲𝐩𝐞𝐬:
● Superficial punctate epithelial erosions - Slightly depressed spots - visible only after staining with fluorescein
● Superficial punctate epithelial keratitis- Greyish white opacities - visible without fluorescein staining, stains poorly with fluorescein and stain well with rose bengal
● Combined epithelial and subepithelial punctate keratitis
Look for associated ocular changes:
1. Conjunctival changes
2. Eyelid lesions
3. Limbal changes
4. Abnormal tear function
Image from Rajan Eye Care Hospital
#superficialpunctatekeratitis #cornea #ocularsurface
