Long-term topical cyclosporin A therapy in Thygeson's superficial punctate keratitis: a case report

PURPOSE To describe a patient with Thygeson's superficial punctate keratitis successfully treated with long-term cyclosporin A. CASE PRESENTATION A 15-year-old boy presented with long-term ocular symptoms of foreign body sensation, burning, irritation, tearing, and transient photophobia. One year's treatment with steroidal agents had led to only partial improvement. Clinical and laboratory evaluation yielded a diagnosis of Thygeson's superficial punctate keratitis. Treatment with 0.5% topical cyclosporin A for the last 4.5 years has been associated with symptom resolution and corneal clearing, without side effects. CONCLUSION Topical cyclosporin A seems to effective and safe for the treatment of Thygeson's superficial punctuate keratitis and should be considered in selective cases when topical steroids fail or in there is a high risk of complications from long-term steroid treatment. Considering the chronicity of Thygeson's superficial punctate keratitis, further prospective studies of long-term cyclosporine A treatment are needed.