Photokeratitis: Symptoms, Treatment and Prevention

Photokeratitis often referred to as "snow blindness," is a painful eye condition caused by the overexposure of the cornea and conjunctiva to ultraviolet (UV) rays.

While it is commonly associated with snowy environments where UV rays are reflected off ice and snow, photokeratitis can occur in any setting where the eyes are exposed to intense UV radiation.

What is Photokeratitis?

Photokeratitis is essentially a sunburn of the eye, affecting the corneal epithelium, which is the outermost layer of the cornea. This condition can be likened to a severe sunburn on the skin, where UV radiation damages the delicate tissues of the eye.

Although it is termed "snow blindness," it is not restricted to snowy areas and can occur on sunny beaches, during high-altitude hiking, or even in tanning salons.

Types of Photokeratitis

Photokeratitis is an eye condition caused by exposure to ultraviolet (UV) rays, leading to temporary corneal damage. It has different types based on the source of UV exposure.

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UV keratitis: Caused by exposure to UV rays from the sun, welding, or tanning beds.
Snow blindness: Results from intense UV reflection off snow or ice.
Welder’s flash: Occurs due to exposure to welding arcs without proper eye protection.
Artificial UV exposure: Caused by UV lamps, lasers, or tanning beds.

Photokeratitis Causes

The primary cause of photokeratitis is prolonged exposure to UV radiation. UV rays are invisible and can penetrate cloud cover, making them insidious and a year-round risk. The sources of UV radiation contributing to photokeratitis include:

Reflected UV Radiation: Snow, water, sand, and concrete can reflect UV rays, increasing exposure.
Direct Sunlight: Direct exposure to sunlight, particularly during midday hours, elevates risk.
Artificial UV Sources: Tanning beds, welding arcs, and some high-intensity lamps can emit UV radiation.

Photokeratitis Symptoms

The photokeratitis symptoms can be quite distressing and typically manifest within a few hours following UV exposure. They may include:

Eye pain and redness
Tearing and watery eyes
Blurred vision
Light sensitivity
Gritty sensation
Swelling of the eyes
Temporary vision loss

Diagnosing Photokeratitis

Diagnosis of photokeratitis typically involves a clinical examination by an ophthalmologist or optometrist. The eye care professional will assess the patient's history of UV exposure and conduct a thorough examination of the eyes.

Using a slit lamp microscope, they can detect damage to the corneal epithelium and confirm the diagnosis. In some cases, a fluorescein dye test may be used to highlight areas of epithelial damage.

Photokeratitis Risk Factors

Several factors can increase the risk of developing photokeratitis. These include:

High Altitude: UV radiation intensity increases with altitude, making mountain climbers and skiers more susceptible.
Reflective Environments: Activities in snowy, sandy, or watery environments increase UV exposure.
Inadequate Eye Protection: Failing to wear UV-blocking sunglasses or goggles leaves the eyes vulnerable.
Prolonged Exposure: Spending extended periods outdoors without eye protection increases risk.

Complications of Photokeratitis

Photokeratitis complications can arise if the condition is not treated properly, leading to prolonged eye discomfort. In severe cases, it may cause vision problems and increase the risk of infections.

Chronic eye irritation: Persistent discomfort and redness.
Blurred vision: Temporary or prolonged vision disturbances.
Increased light sensitivity: Difficulty tolerating bright lights.
Corneal damage: Severe cases may cause lasting corneal issues.
Infection risk: Damaged cornea may lead to bacterial infections.
Tearing and dryness: Ongoing eye moisture imbalance.

Photokeratitis Treatment

Treatment for photokeratitis primarily focuses on alleviating symptoms while the eyes heal naturally. Here are some recommended steps:

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Remove Contact Lenses: If wearing contact lenses, remove them immediately to reduce irritation.
Use Cold Compresses: Applying cold compresses to closed eyelids can help soothe pain and reduce swelling.
Stay Indoors and Rest: Avoid further exposure to bright light and allow the eyes to rest.
Lubricating Eye Drops: Non-prescription artificial tears can relieve dryness and discomfort.
Pain Relievers: Over-the-counter pain medications like ibuprofen can help manage pain and inflammation.

In severe cases, an eye care professional may prescribe antibiotic eye drops to prevent infection or recommend additional treatments. It is essential to follow up with an eye care professional if symptoms persist or worsen.

Photokeratitis Prevention

Photokeratitis eyes can be protected by taking preventive measures to avoid UV exposure. Proper eye care reduces the risk of corneal damage.

Wear UV-protective sunglasses: Blocks harmful rays and prevents eye damage.
Use photokeratitis eye drops: Helps soothe irritation and promote healing.
Avoid direct sun exposure: Stay in shaded areas during peak sunlight hours.
Wear protective eyewear: Use goggles or shields when welding or using UV lamps.
Limit artificial UV exposure: Avoid prolonged use of tanning beds or UV lamps.
Apply wide-brimmed hats: Adds extra protection against UV rays.

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Frequently Asked Questions

Photokeratitis typically does not cause permanent vision loss when treated promptly. However, prolonged or severe exposure can lead to corneal damage, increasing the risk of long-term vision issues.

No, photokeratitis is not contagious. It is caused by UV radiation exposure, either from the sun, snow, or artificial UV sources, and cannot be spread from person to person.

Photokeratitis generally heals within 24 to 48 hours with proper care. Severe cases may take longer, requiring several days for complete recovery, but healing is typically quick if treated appropriately.

Yes, photokeratitis can occur indoors from artificial UV sources like tanning beds, welding arcs, or intense UV lamps. While more common outdoors, any UV exposure can potentially lead to the condition.

Yes, children may be more susceptible to photokeratitis due to their developing eyes being more sensitive to UV radiation. It is crucial to protect their eyes from excessive UV exposure.

While diet alone doesn't prevent photokeratitis, a balanced diet rich in antioxidants like vitamins C and E supports eye health, potentially reducing susceptibility to eye damage caused by UV radiation.

Blue light from screens does not contribute to photokeratitis, which is caused by UV radiation. However, prolonged screen use can lead to digital eye strain, which causes discomfort and other issues.