Thygeson's superficial punctate keratitis: Ten years' experience☆
Presented at: Association of Vision and Research in Ophthalmology Annual Meeting, May, 2002; Fort Lauderdale.
Received 3 December 2002; accepted 3 May 2003.
Abstract
Purpose
To evaluate the presentation, treatment, and disease course of Thygeson's superficial punctate keratitis.
Design
Observational case series.
Participants
Forty patients, diagnosed and managed with Thygeson's superficial punctate keratitis between January 1, 1992, and December 31, 2001, on the Cornea Service at Wills Eye Hospital.
Methods
Retrospective chart review.
Main outcome measures
Patient demographics, symptoms, visual acuity, ophthalmic examination, management, duration of disease, and length of follow-up.
Results
At the time of presentation, the mean patient age was 28.7 years. The most common presenting symptoms included photophobia, blurred vision, and irritation. Thirty of 38 patients without a history of decreased vision (78.9%) initially were seen with visual acuities in both eyes of 20/30 or better. The 8 (21.1%) remaining patients all had visual acuities between 20/40 and 20/50; improvement in vision with treatment was noted in all 3 observed at our institution. Six patients (16%) had unilateral disease, whereas another 2 patients had bilateral involvement develop after unilateral presentation. Thirty-nine patients (97.5%) were treated with topical steroids at some point in their disease course. The patient not managed with steroids was only seen once and was managed with artificial tears for mild symptoms. In addition to steroids, a patient was treated for recurrent episodes with extended-wear contact lens, and another patient was started on topical cyclosporine because of an inability to be tapered off topical steroids. The average duration of disease in the 15 patients who were observed for more than a single year was 11.1 years.
Conclusions
Thygeson's superficial punctate keratitis is a potentially chronic condition, which might affect people of all ages for years to decades. Corticosteroids are the mainstay of treatment, with extended-wear contact lens and topical cyclosporine reserved as secondary agents.
1Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
Correspondence to Christopher J. Rapuano, MD, Cornea Service, Wills Eye Hospital, 840 Walnut Street, Suite 920, Philadelphia, PA 19107, USA.
ABSTRACT