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