Corneal Flash Burns

What are corneal flash burns?

Corneal flash burns are sunburn-like injuries to the corneas of your eyes. The cornea is bowl-shaped and protects the pupil and iris at the front of your eye. Because of where it is, it’s vulnerable to injuries if your eyes aren’t protected. These kinds of burns almost always affect both eyes at the same time.

Types of corneal flash burns

There are two key forms of corneal flash burns:

• Ultraviolet (UV). This is a type of light just outside what the human eye can see. UV-related corneal flash burns are similar to sunburn on skin that wasn’t protected or was exposed for too long. Corneal flash burns from UV rays are also known as UV photokeratitis. And there are several artificial sources of UV rays you might encounter in daily life.
• Thermal. These are heat-related burns. Thermal flash burns involve a sudden, brief exposure to intense heat. The more intense the heat and/or the closer to its source you are, the worse the burn tends to be.

How common are corneal flash burns?

Corneal flash burns are somewhat common. Thermal burns make up the majority of corneal flash burns. But certain activities or being in certain locations can increase your risk of UV flash burns, too.

What are the symptoms of corneal flash burns?

The symptoms of corneal flash burns are largely the same, no matter the type. They include:

• Eye pain (this can be very severe).
• Light sensitivity (photophobia).
• Watery or teary eyes (epiphora).
• Decreased or blurred vision.
• Chemosis (swelling of your conjunctiva).
• Eyelid twitching (blepharospasm).
• Burning sensation in your eyes.

UV-related symptoms may not start right away. It could be as little as 30 minutes or as much as 12 hours after the event that caused the burns.

What can cause corneal flash burns?

The causes of corneal flash burns can vary depending on whether they’re from UV rays or thermal sources.

UV flash burns

One main cause of UV corneal flash burns is reflected sunlight. This mainly happens in two settings:

• Around snow and ice. Snow and ice reflect most of the light that hits them. This is common enough that it has an informal name: “snow blindness.”
• Around large bodies of water. Waterbody surfaces, especially the ocean or large lakes, reflect large amounts of light. If you spend a lot of time around or on a large body of water, you’re at greater risk for developing cornea flash burns.

UV corneal flash burns can also happen from artificial sources. Those include:

• Welding torches. Arc welding, in particular, can cause UV corneal flash burns. When this condition happens from welding, it’s often called “welder’s eye” or “arc eye.”
• Tanning beds. These simulate the sun’s UV rays to cause your skin to tan. But that also means they can cause corneal flash burns if you don’t wear eye protection.
• UV sterilizing equipment. The rays from UV-emitting devices can kill germs and sterilize surfaces. But these devices can also cause corneal flash burns if used incorrectly.
• Faulty high-voltage halogen light bulbs. These are often used for large-scale lighting projects, like gymnasiums, performing arts stages, arenas and stadiums. If the bulb is damaged or bursts, it can cause corneal flash burns, even if you’re not very close to them.

Thermal flash burns

Flash fires and explosions — even small ones — can cause corneal flash burns. Some common ways this happens include:

• Fireworks. Even smaller fireworks can cause corneal flash burns if used improperly.
• Volatile, flammable and inflammable substances. Accelerants — like gasoline, lighter fluid, etc. — can ignite or explode around sparks or open flames. These can cause corneal flash burns if you’re too close to the flame or if igniting the substance causes an explosion.
• Incorrect use or accidents involving explosive gases. Natural gas, propane and similar gases are useful as fuel for heating or cooking. But if they build up in the air around you, they become a fire or explosion risk. High oxygen concentrations, including medical oxygen, can do this, too.

What are the complications of corneal flash burns?

Corneal flash burns can make your eyes more vulnerable to infections. They can also worsen and lead to conditions like recurrent corneal erosions. Fortunately, these complications are treatable and usually don’t become severe.

Similar to how repeated sunburns can raise your risk of melanoma and other skin cancers, UV rays may damage your eyes over time. This may raise your risk of melanoma on the surface of your eye (conjunctival melanoma) or other conditions

How are corneal flash burns diagnosed?

A healthcare provider, usually an emergency medicine or eye care specialist, can diagnose corneal flash burns by looking at your eyes, asking questions about your symptoms and recent activities, and with simple tests.

Many people with thermal corneal flash burns may also have burns on their eyelids or surrounding facial areas. If that’s the case, it can make diagnosing corneal flash burns a little easier.

What tests will be done to diagnose this condition?

There are two main tests for diagnosing corneal flash burns. It’s common for the diagnosing process to involve both. They are:

• Fluorescein staining. This test uses a dye that glows under blue light. A provider can apply it to your eye and see the damaged sections of your cornea directly.
• Slit lamp exam. This test involves a light and magnifying lens that lets a provider see the surface of your eye in greater detail.

How are corneal flash burns treated?

The cornea can repair itself very quickly, so most treatments for corneal flash burns focus on making it easier for your corneas to repair themselves, minimizing other symptoms and preventing complications.

Treatments include:

• Pain management. Corneal flash burns can be very painful. Pain management can involve numbing (anesthetic) medications the provider applies directly to your eyes. They may also recommend pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) you take by mouth to help after the numbing medications wear off. Stronger drugs, like opioids, may help early on for severe flash burns.
• Antibiotics. The cornea is a protective barrier that keeps germs out, and flash burns make it easier for germs to infect your eye. Antibiotic drops or ointments are important for preventing intruding germs from sticking around.
• Eye patch. An eye patch may help protect your eye after a corneal flash burn. However, this isn’t always the case. Your provider can tell you if they recommend it for your injury and situation.

How soon after treatment will I feel better?

The time it takes for you to feel better after a corneal erosion can vary slightly. If you receive numbing medications on your eyes, you should feel relief from the pain within minutes. But once the numbing medication wears off, you might experience some discomfort.

However, your provider will likely guide you on using nonprescription pain medications, like NSAIDs, or prescribe medications to help manage your pain after numbing medications wear off. And the cornea repairs itself very quickly, so your pain level should decrease by the time numbing medications wear off, too.

Can corneal flash burns be prevented?

Yes, corneal flash burns are easily preventable. There are rare cases where corneal flash burns happen because of unexpected events, but that’s usually not the case.

Steps to prevent corneal flash burns are:

• Wear UV-blocking glasses. UV-filtering glasses can make a tremendous difference if you’re in an environment where there’s a lot of reflected sunlight. These are also vital if you work around UV light sources like welding equipment or use tanning beds (but experts also recommend against using tanning beds because there’s no “safe” use of them).
• Wear heat-resistant protective goggles or glasses. If you’re around volatile substances or open flames, goggles can shield your eyes from sudden bursts of flame or heat.
• Use accelerants cautiously. You should only use products specifically intended for starting a fire, and even then, you should use them very carefully. Never use gasoline as a fire starter or around an open flame. And remember, “inflammable” and “flammable” mean the same thing! (“Inflammable” means “can be inflamed.”) Something that isn’t flammable should be marked, “nonflammable.”
• Use great caution with fireworks. While they may seem like fun, you should always remember that fireworks come with risks. Use them cautiously. Young children should never use fireworks unsupervised, and some fireworks aren’t safe for children to use even with supervision.

What can I expect if I have corneal flash burns?

Corneal flash burns are painful, but they heal quickly. You might experience other symptoms like blurred or cloudy vision, watery eyes and feeling pain around bright lights. But these symptoms are usually short-lived and will go away as your corneas heal.

How long do corneal flash burns last?

Fortunately, your corneas can heal rapidly. Corneal flash burns almost always heal within 72 hours. And most will heal within the first day or two.

What’s the outlook for corneal flash burns?

Corneal flash burns are painful, but the outlook is very good with quick treatment. Complications like infections or corneal erosions might happen, but these aren’t common, and they usually respond to treatment, too. And if you have further questions about the outlook for your specific situation, your eye care specialist or healthcare provider is the best person to tell you more.

How do I take care of myself if I have a corneal flash burn?

Don’t delay getting medical attention if you have, or think you could have, a corneal flash burn. UV-related flash burns often don’t cause symptoms until hours after whatever caused them. Prompt medical care can help your current symptoms and keep them from worsening.

Thermal burns anywhere on your face or around your eyes always need medical care. Don’t try to self-treat them or delay getting treatment, as this can prolong the pain and increase the likelihood of infections or other issues in the future.

And if your provider prescribes antibiotics, take them exactly as recommended. Don’t stop taking them once you start feeling better. Taking and finishing these medications exactly as instructed is the best way to avoid the return of an infection or developing an antibiotic-resistant infection.

When should I see my healthcare provider?

An emergency medicine provider can usually diagnose corneal flash burns initially. But they’ll also refer you to see an eye specialist, like an ophthalmologist. You should see that eye specialist as soon as possible. Your eye care specialist will also likely recommend one or more follow-up visits to check how your eyes are recovering and look for lingering issues. You should see them for these visits as scheduled.

When should I go to the emergency room?

After getting corneal flash burns diagnosed and treated initially, most people won’t need further emergency care. But if you notice your pain or your vision is getting worse, you should get emergency care right away.

There might also be reasons specific to your situation that you might need emergency care. Your eye care specialist or provider can tell you what signs you should watch for, and when you should get care.

A note from Cleveland Clinic

Corneal flash burns are a painful but very treatable eye issue. The best thing you can do for yourself if you might have a corneal flash burn is to get care as soon as possible. Don’t try to tough it out. Doing that can lead to an infection or additional problems. Fortunately, the cornea is a very fast-healing part of your body. If you get treatment quickly and follow your provider’s guidance, you should feel better within two or three days (or even sooner).