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Exploring the Causes and Treatments of Punctate Keratitis

Gina Walters


punctate keratitis

Punctate Keratitis is a common eye condition brought on by the damage of tiny clusters of cells on the surface of the cornea.

The inflammation appears as tiny, pinpoint-like ulcers on the corneal surface and could be the result of infections or other eye issues, such as dry eyes.

Punctate Keratitis can lead to red, watery eyes and may affect your vision.

Treatment of Punctate Keratitis depends upon the underlying cause.

In this article, we will focus on the causes and treatment of Punctate Keratitis.

What is Punctate Keratitis

Punctate Keratitis or Superficial Punctate Keratitis is a type of Keratitis characterized by multiple small, pinpoint-like ulcers or damage on the cornea. 

If these ulcers are examined under a microscope or examined during an eye test, they appear as tiny dots or spots.

The following are possible symptoms of Punctate Keratitis:

  • Redness in the eyes
  • Light sensitivity (Photophobia)
  • Discomfort or pain in the eyes
  • Blurry vision
  • Grittiness or a feeling of some foreign substance in the eye
  • Extreme dryness or tearing
If you experience any of these symptoms, it’s essential to consult an eye care specialist. Early diagnosis and suitable treatments can reduce discomfort and prevent complications.

Want to know more about the symptoms of Keratitis? Read our article: Keratitis Symptoms: Understanding the Signs of Corneal Inflammation

Causes of Punctate Keratitis

Several conditions, including bacterial, fungal, or viral infections, dry eye, Blepharitis, and prolonged contact lens wear, can cause Punctate Keratitis.

The microscopic ulcers caused by Punctate Keratitis can also be brought on by exposure to allergens or irritants in the environment and certain autoimmune diseases.


Punctate Keratitis can be brought on by bacterial, fungal, or viral infections. 

These tiny ulcers can be caused by corneal infections induced by viruses, bacteria, and fungi.

Viruses inducing Punctate Keratitis include adenovirus, Herpes simplex virus, and Herpes zoster virus.

Pink Eye or Conjunctivitis is one of the common causes of Punctate Keratitis.

Dry eye

dry eyeSource: Pixeloit
Man suffering from dry eyes

A person with dry eye syndrome will have an unstable tear film, which will result in either insufficient or low-quality tears. 

This can result in dry and inflamed cornea, leading to Punctate Keratitis. 

The infection can be brought on by corneal infection, weakened immune system, and the use of contact lenses.


Blepharitis is the term for inflammation of the eyelids. 

It is brought on by blocked oil-producing glands in the eyelid or microorganisms on the skin. 

This inflammation may destroy the tear film and affect the outer layer of the cornea. 

Use of contact lenses

The risk of Punctate Keratitis can be raised by improper usage or prolonged wear of contact lenses.

Prolonged use of contact lenses can irritate the cornea.

It can also interfere with oxygen delivery to the cornea or introduce bacteria, leading to corneal damage.

This, in turn, can lead to Punctate Keratitis.

Environmental irritants

Exposure to certain chemicals, allergens, or pollutants can irritate the cornea and cause Punctate Keratitis.

Also, UV radiation can damage the surface layer of the cornea, just like a sunburn does to the skin, which can lead to Punctate Keratitis in both eyes.

Autoimmune diseases

Autoimmune disorders can induce inflammation in the eyes, resulting in Punctate Keratitis.

These may include Lupus, Rheumatoid Arthritis, and Sjögren’s disease.

Though Rheumatoid Arthritis is mostly associated with inflammation of the joints, it can also impact the eyes. 

Keratitis can result from inflammation in the cornea and sclera, the white portion of the eye.

Lupus can cause inflammation that can impact the cornea, sclera, and other areas of the eye, resulting in Keratitis and other eye-related problems.

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Punctate Keratitis treatment

Treatment for Punctate Keratitis aims to overcome symptoms, promote healing, and prevent potential complications that might affect vision. 

The underlying cause of Punctate Keratitis must be addressed in order to treat it.

An eye care specialist will identify the underlying reason by reviewing clinical findings, patient history, and symptoms.

Following diagnosis, the physician will recommend the best course of action.

These may include artificial tears, medications, treatment of underlying conditions, contact lens care, and elimination of environmental irritants.

Artificial tears or lubricating eye drops

Use artificial tears eyedropSource: Denisfilm_From_Getty_Images
Use artificial tears eyedrop

Artificial tears or other lubricating eye drops, when used frequently, can assist in lubricating the eye.

While artificial tears don’t directly treat Keratitis itself, they can help in managing the symptoms and promoting healing by moisturizing the eyes, promoting healing, and flushing irritants out of the eyes.


Certain medications may be recommended in situations where the cause is a bacterial, fungal, or viral infection.

These medications include antiviral, antibiotic, or antifungal eye drops or ointments.

Treating underlying conditions

If allergies or autoimmune diseases are the cause of Punctate Keratitis, treating the underlying cause appropriately will help control the symptoms.

Contact lens management

If wearing contacts is the underlying cause of the condition, the doctor can advise switching to a different type of lens.

He may also advise cutting down on how long you wear them, or altering the way you take care of them.

Eliminating environmental irritants

Reducing exposure to allergens or environmental irritants that may be making the condition worse might be helpful in treating Punctate Keratitis.

An antibiotic eye drop or ointment that dilates the pupil may help if UV light exposure is responsible for the condition.

Bacterial eye infections can be managed effectively with antibiotics. Read our article: Understanding Antibiotics for Eye Infections to know more.

Avoid self-medication. Self-medication or applying eye drops without a doctor’s guidance might make the situation worse.


Punctate Keratitis is an eye disorder that causes minute, pinpoint-like ulcers or erosions on the cornea’s surface.

Infections, dry eye syndrome, contact lens usage, environmental variables, and autoimmune illnesses can all lead to Punctate Keratitis.

Symptoms of the condition include eye irritation, redness, sensitivity to light, and blurred vision.

Treatment of Punctate Keratitis may involve the use of artificial tears and medications (such as antiviral, antibiotic, or anti-inflammatory eye drops).

Also treating underlying disorders and avoidance of potential irritants or triggers may help.

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Frequently Asked Questions

How do you get Punctate Keratitis?

Eye infections, dry eyes, prolonged use of contact lenses, and environmental factors can lead to Punctate Keratitis.

What does Punctate Keratitis look like?

Punctate keratitis usually manifests as several tiny pinpoint-like ulcers or patches on the cornea’s surface. 
The distribution and size of these ulcers might differ.
These ulcers may appear as minute dots or patches dispersed across the cornea during an eye examination or when seen under a slit-lamp microscope. 

Is Punctate Keratitis chronic?

Punctate Keratitis is not always a chronic condition; the underlying cause determines whether the illness is chronic.
For example, the symptoms of Punctate Keratitis may last or reoccur frequently if the cause is a chronic illness such as dry eye syndrome or autoimmune disorders.

How long does Superficial Punctate Keratitis take to heal?

When treated properly with medications, such as topical Gatifloxacin 0.5% eye drops six times a day for 10 days, the patients recover after 10 days.
However, the dose and medicine should be discussed with the doctor first.

How do you distinguish between Superficial Punctate Keratitis and Punctate Epithelial Keratitis?

Superficial Punctate Keratitis is caused by microscopic, dispersed damage sites to the cornea’s outer surface layer (epithelium). 
On the other hand, Punctate Epithelial Keratitis is characterized by tiny areas of damaged tissue within the epithelium.

What do you mean by Thygeson Superficial Punctate Keratitis?

Thygeson Superficial Punctate Keratitis (TSPK) is a long-term, frequently bilateral, recurrent disease characterized by several intraepithelial corneal ulcers that are white-gray in color.
This chronic eye inflammation can result in the development of Superficial Punctate Keratitis in the form of round-shaped gray patches in the corneas of both eyes.

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