On inspection with a slit lamp, tiny lumps can be found on the cornea of the eye.

These lumps can be more easily seen after applying fluorescein or rose Bengal dye eye-drops.

The lumps appear to be randomly positioned on the cornea and they may appear and disappear over a period of time (with or without treatment).

[3] There are no proposed diagnostic criteria for TSPK, but its diagnostic features are "(1) the presence of bilateral punctate epithelial keratitis; (2) a chronic course with exacerbations and remissions; (3) healing without scar formation; (4) no response to antibiotics; and (5) a striking symptomatic response to topical corticosteroids.

Symptoms may disappear if untreated, but treatment may decrease both the healing time and the chances of remission.