Encyclopedia of Ophthalmology

Living Edition
| Editors: Ursula Schmidt-Erfurth, Thomas Kohnen

Punctate Epithelial Defects/Erosions

Living reference work entry
DOI: https://doi.org/10.1007/978-3-642-35951-4_929-1



A breakdown of healthy corneal epithelium resulting in pinpoint defects with positive fluorescein, lissamine green, or rose bengal staining seen via a slit-lamp examination.


Tear film instability, desiccation, or inflammatory changes of the cornea resulting in a breakdown of the healthy epithelium. Causes include infectious, allergic, neurologic, toxic, or autoimmune diseases. Inflammation from these diseases leads to a secondary tear deficiency that may then lead to further epithelial disruption.


PEE is a nonspecific sign that occurs in many disease processes, usually as a result of instability of the tear film. The location and pattern of the PEE are important to determine the causative agent.


A full medical history should be conducted targeting autoimmune disorders, infiltrative processes, infectious causes, neuropathic disorders, and endocrine dysfunction. During examination, one of the...

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Further Reading

  1. Krachmer J, Mannis M, Holland E (2013) Cornea: fundamentals of cornea and external disease. Mosby, St. LouisGoogle Scholar
  2. (2011–2012) Basic clinical science course: external disease and cornea. American Academy of OphthalmologyGoogle Scholar

Copyright information

© Springer Science Business Media, New York (outside the USA) 2014

Authors and Affiliations

  1. 1.Krieger Eye InstituteBaltimoreUSA