Photokeratitis

What is photokeratitis?

Photokeratitis is a painful eye condition caused by exposure to ultraviolet (UV) rays, most commonly from the sun. You can compare photokeratitis to sunburn, but it’s a burn that affects parts of your eye instead of your skin. It’s generally bilateral (affects both eyes).

Exposure to UV rays can cause damage to both the cornea and conjunctiva of your eye. In addition to the sunlight or reflected sunlight, other sources of UV rays include welding arcs, tanning equipment and lights used for medicine.

Sometimes, people call this condition a name that reflects the cause. For instance, snow blindness is a type of photokeratitis that occurs when snow and ice reflect UV rays. It’s more common near the North and South Poles or in mountainous regions where the air is thinner and provides less protection against UV rays. People who get photokeratitis from welding may say they have arc eye or welder’s flash.

Types of photokeratitis

Photokeratitis can be acute or chronic.

• Acute photokeratitis, a temporary condition, happens after a short exposure to higher levels of UV light.
• Chronic photokeratitis happens after exposure to lower levels of UV light over time. This type is less common than acute photokeratitis.

What are the symptoms of photokeratitis?

If you have photokeratitis, you may experience one or more of the following symptoms:

• Eye pain or redness.
• Tearing/watery eyes.
• Blurry vision.
• Swelling.
• Light sensitivity.
• Gritty sensation in your eyes.

Other symptoms include:

• Seeing halos.
• Headaches.
• Twitching of your eyelids.
• Temporary vision loss (rare).
• Color changes in your vision (rare).

The symptoms may last from six to 24 hours, but they usually disappear within 48 hours. The longer you’re exposed to UV light, the more severe your symptoms might be.

What causes photokeratitis?

Ultraviolet rays can damage your eyes. UV-A and UV-B rays from the sun can cause short- and long-term damage to your eyes and affect your vision. The ozone layer absorbs UV-C radiation, so those rays don’t damage your eyes.

Besides direct sunlight, other sources of ultraviolet light that can cause photokeratitis include:

• Sunlight that’s reflected into your eyes from snow, ice, water, sand or cement.
• Lamps used in tanning beds or booths.
• Laser light.
• Mercury vapor lamps or halogen desk lamps.
• Lightning or electric sparks.
• Arc welding equipment or photographic flood lamps.
• Light used to disinfect or used as medical treatment.

Staring directly at the sun, such as during a solar eclipse, can cause more long-lasting and considerable damage — a burn — to your retina.

What are the risk factors for photokeratitis?

You’re at greater risk of getting photokeratitis if you:

• Spend a lot of time outdoors in the sun, doing activities like mountain climbing, hiking, skiing swimming.
• Use a sunlamp, tanning bed or work or spend time in environments where there’s a UV light source.
• Live in higher altitudes (greater exposure to UV rays) or in the U.S. sunbelt, which is the southern part of the country below the 36th parallel.

What are the complications of photokeratitis?

Long-term exposure to even small amounts of UV radiation can increase your risk of developing a cataract or macular degeneration. UV exposure adds up over time. Long-term UV exposure can also cause tissue elevations on the surface of your eye. These are called pingueculae and pterygia. Using sunglasses faithfully when outdoors may limit these.

Blue and violet shorter-wavelength visible light, emitted from LED lights, computers and smartphones, can also be harmful to your retina and be a risk factor for macular degeneration later in life.

How is photokeratitis diagnosed?

An eye care specialist will examine your eyes and ask you questions about your recent activities and work environment. An ophthalmologist can determine if you have eye damage and how severe it is.

What tests will your provider use to diagnose photokeratitis?

Your provider will put drops with fluorescein into your eye and then perform a slit lamp exam. Fluorescein is a dye that can reveal irregularities on the surface of your cornea.

How is photokeratitis treated?

If you experience symptoms, go indoors immediately. Stay in a darkened room. Remove your contact lenses if you wear them. Don’t rub your eyes.

Your provider may suggest these types of home remedies:

• Rest with your eyes closed.
• Place a cold washcloth over your closed eyes.
• Wear sunglasses to reduce exposure to light.
• Use artificial tears.
• Take an oral over-the-counter nonsteroidal anti-inflammatory drug like ibuprofen (Advil®, Motrin®).

Usually, the condition goes away on its own within a few hours to days. If medical treatment is necessary, your doctor may prescribe eye drops to prevent infection.

Seek medical attention if you experience a loss of vision or pain that lasts for more than two days.

How can I prevent photokeratitis?

You can prevent photokeratitis by:

• Wearing proper eye protection, like sunglasses or snow goggles. Researchers recommend sunglasses or goggles that block or absorb 99% to 100% of UV rays if you spend time outdoors. The best choice may be wrap-around sunglasses or those with side panels to block all harmful UV rays. Glare from the snow, sand or water can cause burns to your eyes even if it’s cloudy or overcast.
• Wearing a wide-brimmed hat or visor when you go outdoors.
• Using proper eye protective equipment if you’re exposed to UV radiation on the job.
• Wearing UV-absorbing contact lenses if you work or play in sunny environments.
• Seeing an eye care specialist at least once a year for a complete eye exam.

What can I expect if I have photokeratitis?

The good news about photokeratitis is that it’s almost always a temporary condition, and your symptoms usually go away within a few hours to a couple of days. You can relieve most symptoms with at-home remedies.

You may need to stay inside for a day or so while you recover.

When should I see a doctor about photokeratitis?

If you have symptoms of eye pain or vision loss after being outside or being around UV rays, you should contact a healthcare provider. Let them know that you were around sources of UV light, such as the sun or welding equipment. Your provider is the best person to decide if your symptoms are those of photokeratitis or not.

Your provider can suggest things you can do at home to help yourself and can advise you when you need to get medical attention.