Thygeson's Superficial Punctate Keratopathy is typically characterized by which pattern?

• A. Unilateral with chronic course
• B. Bilateral with remissions
• C. Severe pain and photophobia as primary symptoms
• D. Rapid progression to corneal thinning

Answer: (B)

Thygeson’s keratopathy is a chronic, relapsing superficial keratitis that most often affects both eyes in a bilateral, symmetrical pattern. During flares you see superficial punctate epithelial erosions in the central to paracentral cornea that stain with fluorescein, but the symptoms are usually mild—pain and photophobia are not dominant. Between episodes the cornea returns to normal and symptoms remit, which is why the condition is described as having remissions. This bilateral, episodic course helps distinguish it from unilateral, rapidly progressive infectious keratitis and from conditions with more severe pain or corneal thinning. It’s often responsive to topical steroids and carries a favorable prognosis.