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Photokeratitis
Photokeratitis is a painful eye condition caused by acute exposure to ultraviolet radiation that damages the surface of the cornea. It is often described as a sunburn of the eye. The cornea absorbs ultraviolet light, and excessive exposure injures the corneal epithelial cells, leading to inflammation and temporary visual disturbance. Although symptoms can be severe, permanent damage is uncommon when treated appropriately.
Symptoms: Symptoms typically begin several hours after ultraviolet exposure.
· Eye pain or burning sensation.
· Redness of the eyes.
· Excess tearing.
· Sensitivity to light.
· Blurred vision.
· Gritty or foreign-body sensation.
· Swollen eyelids.
· Headache in some cases.
· Temporary decrease in visual clarity.
Causes: Photokeratitis results from excessive ultraviolet radiation exposure to the cornea.
· Sunlight exposure: Risk increases in environments where ultraviolet rays are intensified or reflected. Snow and ice environments may cause snow blindness. High altitudes increase ultraviolet radiation intensity. Beaches and water surfaces reflect sunlight and increase exposure.
· Artificial ultraviolet sources: Welding arcs may cause welder’s flash or arc eye. Tanning beds and certain industrial lamps may emit harmful ultraviolet radiation. Broken or unshielded ultraviolet lamps may increase exposure risk.
· Inadequate eye protection: Failure to wear appropriate ultraviolet-blocking eyewear significantly increases risk.
Diagnosis and Tests:
· Diagnosis is based on history of recent ultraviolet exposure and clinical examination.
· A slit-lamp examination evaluates the corneal surface.
· Fluorescein dye staining may reveal superficial punctate epithelial defects.
Management and Treatment: Treatment focuses on relieving discomfort and supporting corneal healing.
· Supportive treatment: Lubricating artificial tears protect the ocular surface. Cold compresses may reduce discomfort. Contact lenses should be avoided during recovery. Resting the eyes in dim lighting may improve comfort.
· Pain management: Short-term oral pain medication may be recommended in moderate cases. Cycloplegic drops may be used in selected cases to reduce discomfort.
· Antibiotic prophylaxis: A topical antibiotic may be prescribed to reduce the risk of secondary infection while the cornea heals.
· Healing timeline: The corneal epithelium regenerates quickly. Most patients improve significantly within 24 to 48 hours. Full recovery typically occurs within several days.
Prognosis: The prognosis is generally excellent. Superficial ultraviolet damage usually heals without scarring. Repeated ultraviolet injury should be avoided to protect long-term ocular health.
Prevention:
· Wear sunglasses that block 100 percent of ultraviolet radiation.
· Use protective goggles during welding or industrial exposure.
· Wear wraparound eyewear in high-reflection environments.
· Avoid tanning beds and unregulated ultraviolet light sources.
When Should I See My Healthcare Provider? Seek medical evaluation if pain is severe, vision remains blurred beyond 48 hours, or symptoms worsen.
When Should I Go to the Emergency Room? Go immediately if vision decreases significantly, severe pain prevents opening the eyes, or chemical exposure is suspected.
What Questions Should I Ask My Healthcare Provider?
· Is this photokeratitis or another corneal injury?
· How long should symptoms last?
· When can I return to normal activities?
· Do I need prescription medication?
· How can I prevent future ultraviolet injury?
Key Takeaways:
· Photokeratitis is ultraviolet-induced corneal injury.
· Symptoms often appear several hours after exposure.
· Most cases resolve within 24 to 48 hours.
· Proper ultraviolet eye protection prevents injury.
· Repeated ultraviolet exposure should be avoided.