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Superficial Punctate Keratitis

By

Melvin I. Roat

, MD, FACS, Sidney Kimmel Medical College at Thomas Jefferson University

Reviewed/Revised Aug 2022
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Superficial punctate keratitis is corneal inflammation of diverse causes characterized by scattered, fine, punctate corneal epithelial loss or damage. Symptoms are redness, lacrimation, photophobia, and slightly decreased vision. Diagnosis is by slit-lamp examination. Treatment depends on the cause.

Superficial punctate keratitis is a nonspecific finding. Causes may include any of the following:

Symptoms include photophobia, foreign body sensation, lacrimation, redness, and slightly decreased vision.

Keratitis that accompanies adenovirus conjunctivitis resolves spontaneously in about 3 weeks. Blepharitis Blepharitis Blepharitis is inflammation of the eyelid margins that may be acute or chronic. Symptoms and signs include itching and burning of the eyelid margins with redness and edema. Diagnosis is by history... read more Blepharitis , keratoconjunctivitis sicca Keratoconjunctivitis Sicca Keratoconjunctivitis sicca is chronic, bilateral desiccation of the conjunctiva and cornea due to an inadequate tear film. Symptoms include itching, burning, irritation, and photophobia. Diagnosis... read more Keratoconjunctivitis Sicca , and trachoma Trachoma Trachoma is a chronic conjunctivitis caused by Chlamydia trachomatis and is characterized by progressive exacerbations and remissions. It is the leading cause of preventable blindness... read more Trachoma require specific therapy. When caused by overwearing contact lenses, keratitis is treated with discontinuation of the contact lens and an antibiotic ointment (eg, ciprofloxacin 0.3% four times a day), but the eye is not patched because serious infection may result. Contact lens wearers with superficial punctate keratitis should be examined the next day. Suspected causative topical drugs (active ingredient or preservative) should be stopped.

Ultraviolet keratitis

Ultraviolet (UV) B light (wavelength < 300 nm) can burn the cornea, causing keratitis or keratoconjunctivitis. Arc welding is a common cause; even a brief, unprotected glance at a welding arc may result in a burn. Other causes include high-voltage electric sparks, artificial sun lamps, and sunlight reflected off snow at high altitudes. UV radiation increases 4 to 6% for every 1000-ft (305-m) increase in altitude above sea level, and snow reflects 85% of UVB.

Symptoms are usually not apparent for 8 to 12 hours after exposure and last 24 to 48 hours. Patients have lacrimation, pain, redness, swollen eyelids, photophobia, headache, foreign body sensation, and decreased vision. Permanent vision loss is very rare.

Diagnosis is by history, presence of superficial punctate keratitis, and absence of a foreign body or infection.

Treatment consists of an antibiotic ointment (eg, bacitracin or gentamicin 0.3% ointment every 8 hours) and occasionally a short-acting cycloplegic drug (eg, cyclopentolate 1% drop every 4 hours). Severe pain may require systemic analgesics (eg, acetaminophen 500 mg every 4 hours for 24 hours). The corneal surface regenerates spontaneously in 24 to 48 hours. The eye should be rechecked in 24 hours. Dark glasses or welder’s helmets that block UV light are preventive.

Drugs Mentioned In This Article

Drug Name Select Trade
AK-Fluor, Bio Glo, Fluorescite, Fluorets , Fluor-I-Strip, Fluor-I-Strip A.T., Ful-Glo, Ophthalmicflur
Cetraxal , Ciloxan, Cipro, Cipro XR, OTIPRIO, Proquin XR
AK-Tracin, Baciguent, BaciiM, Baci-Rx, Bacitracin Zinc, Ocu-Tracin
Garamycin, Genoptic, Genoptic SOP, Gentacidin, Gentafair, Gentak , Gentasol, Ocu-Mycin
AK-Pentolate , Cyclogyl, Cylate, Ocu-Pentolate
7T Gummy ES, Acephen, Aceta, Actamin, Adult Pain Relief, Anacin Aspirin Free, Aphen, Apra, Children's Acetaminophen, Children's Pain & Fever , Children's Pain Relief, Comtrex Sore Throat Relief, ED-APAP, ElixSure Fever/Pain, Feverall, Genapap, Genebs, Goody's Back & Body Pain, Infantaire, Infants' Acetaminophen, LIQUID PAIN RELIEF, Little Fevers, Little Remedies Infant Fever + Pain Reliever, Mapap, Mapap Arthritis Pain, Mapap Infants, Mapap Junior, M-PAP, Nortemp, Ofirmev, Pain & Fever , Pain and Fever , PAIN RELIEF , PAIN RELIEF Extra Strength, Panadol, PediaCare Children's Fever Reducer/Pain Reliever, PediaCare Children's Smooth Metls Fever Reducer/Pain Reliever, PediaCare Infant's Fever Reducer/Pain Reliever, Pediaphen, PHARBETOL, Plus PHARMA, Q-Pap, Q-Pap Extra Strength, Silapap, Triaminic Fever Reducer and Pain Reliever, Triaminic Infant Fever Reducer and Pain Reliever, Tylenol, Tylenol 8 Hour, Tylenol 8 Hour Arthritis Pain, Tylenol 8 Hour Muscle Aches & Pain, Tylenol Arthritis Pain, Tylenol Children's, Tylenol Children's Pain+Fever, Tylenol CrushableTablet, Tylenol Extra Strength, Tylenol Infants', Tylenol Infants Pain + Fever, Tylenol Junior Strength, Tylenol Pain + Fever, Tylenol Regular Strength, Tylenol Sore Throat, XS No Aspirin, XS Pain Reliever
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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