Photokeratitis

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  • = Corneal “sunburn”, ultraviolet keratitis, welder’s eye, arc eye, snow blindness

Clinical Presentation

  • Symptoms: severe pain, foreign body sensation, red eye, photophobia, watery eye, tearing
  • Caused by strong UV radiation, typically following welding or intense sunlight exposure in high-altitude areas
  • Onset usually 6 – 12 hours after exposure
  • Findings: superficial punctate keratitis, corneal epithelial defects in the palpebral fissure, red conjunctival injection, possibly mild anterior chamber flare/cells

Treatment

  • Lacrycon gtt / Lacrinorm gel hourly + Vitamin A ointment at night (or during day)
  • Topical antibiotic therapy for corneal epithelial defects, e.g. Floxal (ofloxacin) gtt 4x/d
  • +/- Cycloplegia (e.g., Scopolamine twice daily)
  • +/- eye bandage or therapeuticcontact lenses
  • Analgesics as needed
  • Do not give local anaesthetics to the patient

Prognosis

  • Typically heals within 24-72 hours

Sources

  • EyeWiki Photokeratitis
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)
  • Kanski‚Äôs Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)