Case Report February 04, 2026 February 04, 2026

Thygeson’s keratitis with post-corticosteroid recurrence in a child: sustained response to topical immunomodulation with tacrolimus

DOI: 10.37039/1982.8551.20260006

ABSTRACT

Thygeson’s keratitis is a chronic bilateral inflammation of the cornea, characterized by recurrent intraepithelial opacities, intense photophobia, and visual fluctuations, especially in children. Topical corticosteroids are effective, but their prolonged use carries risks and frequent recurrences. We report the case of an 11-year-old girl with refractory Thygeson’s keratitis treated with topical tacrolimus 0.03%. After an initial response to corticosteroids, an early recurrence occurred within 15 days. With the introduction of tacrolimus, there was complete resolution of signs and symptoms, with sustained control and no adverse effects. Clinical follow-up lasted 8 months, including serial evaluation and photographic documentation. Topical tacrolimus 0.03% proved to be a safe and effective immunomodulatory alternative, reducing corticosteroid dependence and its associated complications. This case highlights the potential of tacrolimus in the long-term management of pediatric Thygeson’s keratitis.