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