Thygesons Superficial Punctate Keratopathy

Topical Therapy in Thygeson’s Superficial Punctate Keratitis

When someone is affected by the severity of Thygeson’s Superficial Punctate Keratitis or in any of its signs, symptoms, or following remission, various therapies are considered depending on the severity of the disease at the time the patient presents to the eye care specialist.

Where a patient presents with a mild case, then they may be prescribed preservative-free artificial tears to keep the eyes lubricated to alleviate the sensations associated with the conditions such as the feeling that there is something in the eye. More likely, if patients are presenting with an inflammation caused by Thygeson’s SPK, then the patient will likely be prescribed a mild topical steroid. Prolonged steroid use is not recommended, while short-term use of steroids such as those made by Allergan or FML containing Fluorometholone 0.1% will be effective. Bausch & Lomb or Lotemax make eye drops containing Loteprednol 0.5% used four times per day tapered off over a period of weeks can also be effective. For persistent cases, bandage contact lenses might be an effective longer-term therapy. For some patients, the topical application of Trifluridine, an antiviral therapy, has shown some benefits too.

Cyclosporine 2% is used effectively in clinical studies as a therapy, which resulted in 72 percent of adults finding the treatment suppressed subepithelial and epithelial corneal opacities, and with further treatment, about a third of those patients did not have recurrences of Thygeson’s SPK. The effects of more commercially available solutions of Cyclosporine (0.05% by Restatis or Allergan) are less known, but may be effective where there is a contraindication of the use of topical steroids or in resistant patients.

Cyclosporine A is a immunomodulator that is used in the treatment of various keratoconjunctivitis conditions. At low concentrations, there was no systemic side affects associated with topical ophthalmic use. In this way, Cyclosporine is a safer alternative to topical steroid treatments. Cyclosporine should be considered for young patients or as the first course of therapy in selective cases.

Even with this advice, there is still a risk that their Thygeson’s Superficial Punctate Keratitis will recur in the future.

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