Photokeratitis is a painful eye condition caused by too much exposure to ultraviolet (UV) light. It is often described as a sunburn of the cornea, which is the clear front surface of the eye.
Symptoms usually do not start right away. Eye pain, redness, tearing, light sensitivity and blurry vision can appear several hours after UV exposure, and most cases improve within 24 to 48 hours with proper care.
Treatment focuses on relieving discomfort while the eye heals. Medical care is important if symptoms are severe, vision changes occur, or symptoms do not improve as expected.
Main symptoms
The main symptoms of photokeratitis usually appear 6 to 12 hours after UV exposure and can affect one or both eyes.
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Eye pain or burning
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Red eyes
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Watery eyes
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Sensitivity to light
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Blurry vision
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A gritty or foreign body sensation in the eye
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Eyelid twitching or difficulty keeping the eyes open
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Headache
Symptoms are usually temporary, but they can be very uncomfortable. Most cases improve within 1 to 2 days once UV exposure stops and the eye surface begins to heal.
Common causes
Photokeratitis happens when UV light damages the outer layer of the cornea. It is not contagious and cannot be transmitted from one person to another.
1. Sun exposure
Strong sunlight can cause photokeratitis, especially when the eyes are not protected. The risk is higher in places where UV rays reflect strongly, such as snow, water, sand or high-altitude areas.
This is why photokeratitis is sometimes called snow blindness. It can happen during skiing, hiking, boating, beach activities or other outdoor activities with intense UV exposure.
2. Welding arcs
Welding can produce intense UV radiation that may burn the surface of the eye. This type of photokeratitis is often called arc eye.
The condition can occur when welding goggles or proper face shields are not used. It may also affect people nearby if they look at welding light without protection.
3. Tanning beds and artificial UV lamps
Tanning beds and some artificial UV lamps can also cause photokeratitis. These devices expose the eyes to UV light that can injure the cornea, especially when protective eyewear is not worn.
UV disinfection lamps have also been linked to cases of photokeratitis. This can happen when lamps are used incorrectly in homes, workplaces or public spaces.
4. Recreational or event-related UV exposure
Photokeratitis can also occur after exposure to UV displays, stage lighting or other recreational light sources. Case reports have described photokeratitis after outdoor events and theater shows involving UV radiation.
These cases show that eye injury from UV light is not limited to workplaces. It can also happen in schools, entertainment settings and public events.
Confirming a diagnosis
Diagnosis is usually made by an eye doctor or another trained health professional based on symptoms, recent UV exposure and an eye exam. A history of sunlight, welding, tanning bed use, UV lamps or stage lighting exposure can strongly support the diagnosis.
During the exam, the doctor may use a slit lamp to look closely at the cornea. Fluorescein dye may also be placed in the eye to help show small surface injuries, often seen as superficial punctate epithelial defects.
Doctors also check for other possible causes of eye pain and redness, such as infection, a foreign body in the eye or other corneal injuries. This helps confirm photokeratitis and guide the safest treatment plan.
Treatment options
Photokeratitis is usually self-limited, which means it often improves as the cornea heals. Treatment is mainly used to reduce pain, prevent complications and protect the eye while it recovers.
1. Supportive care
Resting the eyes and avoiding more UV exposure are important while healing. Lubricating eye drops or artificial tears may help reduce dryness and irritation.
Cold compresses may also help with discomfort. Contact lenses should not be worn until the eye has healed and a doctor says it is safe.
2. Pain relief
Pain relievers may be recommended to reduce discomfort. Some cases may also require eye drops prescribed by a doctor to help control pain.
Eye pain from photokeratitis can be intense, even though the condition usually improves quickly. Medical guidance is important before using medicated eye drops, especially anesthetic drops, because some can harm the eye if used incorrectly.
3. Antibiotic eye drops or ointment
A doctor may prescribe antibiotic eye drops or ointment in some cases. These are used to lower the risk of a secondary infection while the corneal surface heals.
Antibiotics do not treat the UV injury itself. They may be recommended when there are visible corneal surface defects or when the doctor thinks infection prevention is needed.
4. Follow-up care
Most cases improve within 24 to 48 hours. Follow-up may be needed if symptoms last longer than expected, become worse, or if vision does not return to normal.
Urgent medical care is recommended for severe eye pain, major vision changes, pus-like discharge, symptoms after a chemical exposure, or symptoms that do not improve after 1 to 2 days.
Prevention measures
Photokeratitis can often be prevented by protecting the eyes from UV light.
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Wear sunglasses that block 100% of UV rays
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Use wraparound sunglasses or goggles in snow, water, sand or high-altitude environments
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Wear proper welding goggles or face shields when welding
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Avoid looking directly at welding arcs, tanning lamps or UV disinfection lamps
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Use protective eyewear during tanning bed use
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Follow safety instructions for UV lamps and occupational UV equipment
Good eye protection is especially important because symptoms may not appear until hours after the damage has already happened. Preventing UV exposure is the best way to avoid photokeratitis.