Ultraviolet keratitis: Difference between revisions
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#High UV exposure can lead to corneal burns w/in 1hr | #High UV exposure can lead to corneal burns w/in 1hr | ||
##May also see with arc welders, tanning beds | ##May also see with arc welders, tanning beds | ||
==See Also== | ==See Also== | ||
Revision as of 03:38, 13 June 2012
Background
- Also known as photoconjunctivitis, welder's flash, snow blindness
- Prolonged/excessive UV exposure to eyes leads to inflammatory response and subsequent desquamation of corneal epithelium leaving exposed nerve endings of cornea
Causes
- Lack of proper eye protection
- UV exposure from
- Natural sources : snow, water, high altitudes (less protective ozone), eclipses
- Artificial sources: Welder's arc, tanning beds, damaged metal halide lamps/lights
Clinical Features
- Symptoms occur typically 6-12 hrs after exposure (will present late night/early AM)
- Symptoms include bilateral eye pain, foreign body sensation, lacrimation, blepharospasm, photophobia, chemosis, temporary decreased visual acuity
Work-Up
- History of recent UV exposure
- Full eye exam/Slit Lamp
- Surrounding eyelid skin and face may appear mildly erythematous, edematous consistent with sunburn
- Pt. with obvious tearing, discomfort, blepharospasm throughout exam with relief of symptoms upon instilling topical anesthetic
- Fluoroscein
- Superficial Punctate Keratitis-Small, pinpoint areas of increased uptake on cornea
- Superficial Punctate Keratitis-Small, pinpoint areas of increased uptake on cornea
DDx
- Viral conjunctivitis
- Thygeson's Superficial Punctate Keratitis
- Dry eyes
Treatment
- Self resolution as cornea re-epithelializes in 48-72 hrs
- Very painful-Provide PO NSAIDS, Opiates. If elderly consider topical anesthetics (ie tetracaine if unable to tolerate opiates. Ensure good follow up and pt/family is reliable as to avoid further corneal injury)
- Eye rest-avoid reexposure
- Lacrilube, Saline eye gtts
- +/- Antibiotic ointment (erythromycin ophthalmic or gentamycin ophthalmic)
- +/- Cycloplegics
Disposition
- F/U with PMD in 1-2 days to ensure improvement of symptoms and possible ophtho if no improvement
- Most do not need ophtho f/u given limited course
- Emphasize proper eye protection with future exposure
See Other
Source
UptoDate, Emedicine, Rosen's, Harwood and Nuss
Background
- High UV exposure can lead to corneal burns w/in 1hr
- May also see with arc welders, tanning beds
See Also
Source
Tintinalli