[Thygeson's keratitis--clinical characteristics and therapy].
PURPOSE: The evaluation of clinical manifestations and therapeutical modalities Thygeson's keratitis (Thygeson's superficial punctate keratitis-TSPK) in a group of patients with long follow-up in the Cornea and Immunology Clinic of the Department of Ophthalmology, General Teching Hospital, Charles University in Prague. PATIENTS AND METHODS: The group of 7 patients (13 eyes) at the mean age of 20.7 years (9-39) with clinical diagnosis of TSPK was evaluated retrospectively. The course of the disease, symptoms and signs of the disease, efficacy of the therapy and primary established diagnosis were evaluated. RESULTS: The average onset of the disease was 12.5 years (6-27) and the average duration was 6 years (2-10). TSPK was bilateral in six patients, while unilateral the disease was only in one patient. The clinical picture was characterized by recurrent episodes of photophobia, tearing and burning and foreign body sensation in the eyes. The examination revealed whitish fine granular asterisk-form or dendriform intraepithelial opacities, sometimes slightly above the niveau of the surrounding epithelium. In the acute phase the corneal epithelium above the lesions was disrupted. Subjective symptoms and sometime also the objective findings diminished after local corticosteroids administration. The most common primary diagnoses the TSPK patients were treated for herpetic keratitis. CONCLUSION: TSPK is a rare, relapsing corneal disease with the onset mostly in the first and third decade of life. TSPK is mostly bilateral, but may be also unilateral and findings are asymmetrical in almost all cases. Relapses frequently occur in connection with physical or psychological stress. Concerning the permanent damage to the cornea and potential to decrease visual acuity TSPK can be considered as a benign and during several years self-limited disease. Subjective symptoms however may significantly deteriorate patient's quality of life. Local treatment with corticosteroids diminishes subjective symptoms, number and duration of relapses but does not cure the disease. The disease is often misdiagnosed and treated incorrectly.