15763 Photokeratitis

Overview

Photokeratitis is a painful eye condition caused by overexposure of the eye to ultraviolet (UV) light. It is like a sunburn, but on the clear front surface of the eye called the cornea. The condition usually heals within a day or two without lasting damage.

Photokeratitis is quite common, especially in the summer when people are outdoors more, in snowy areas where UV light reflects intensely, or in workplaces involving welding without proper eye protection.

It can affect anyone at any age. People who spend long hours in bright sunlight, on the water, in the snow, or near tanning beds and welding equipment are at higher risk. Children and outdoor workers are also frequently affected.

Symptoms

Common symptoms

• Eye pain or burning sensation
• Redness of the eye
• Sensitivity to light (photophobia)
• Watery eyes
• Feeling like there is sand or grit in the eye
• Swollen eyelids
• Blurry vision
• Headache

Symptoms in children

• Children may rub their eyes and cry because of pain or light sensitivity.
• They may squint or close their eyes tightly indoors or outdoors.
• Symptoms can be harder to describe, so watch for unusual fussiness or avoiding bright areas.

Symptoms in older adults

• Older adults may experience more severe dryness and discomfort.
• Existing eye conditions, like cataracts or dry eye, can make symptoms feel worse.
• Healing may take a little longer, and older adults are more prone to infections.

Causes

Main causes

• Prolonged exposure to UV light from the sun, especially around water, snow, or sand that reflects the light
• Using tanning beds or sunlamps without proper eye protection
• Welding arcs or other industrial light sources
• Reflection of sunlight from ice or snow (snow blindness)
• Very bright artificial light, such as in photography lighting or certain laboratory equipment

Risk factors

• Spending time at high altitudes, where UV rays are stronger
• Being outdoors at midday when UV light is strongest
• Working in professions like welding, construction, or photography
• Not wearing sunglasses or safety goggles with UV protection
• Using medications that make the eyes more sensitive to light (photosensitizing drugs)
• Having lighter-colored eyes, which may be more sensitive to light

When to see a doctor

See a doctor urgently if:

• If you have severe eye pain that does not go away with simple comfort measures
• If your vision becomes noticeably blurred or you lose vision
• If you have a known eye disease or a weakened immune system
• If symptoms last longer than 24 hours or get worse

Book a routine appointment if:

• If you have mild symptoms but want to confirm the diagnosis and rule out other causes
• If you need work or school notes for time off due to eye discomfort
• If you have repeated episodes and want advice about better eye protection

Diagnosis

A doctor or eye specialist will ask about your symptoms and what you were doing before the pain started – for example, being in the snow, near water, or around welding equipment. They will then examine your eyes with a special microscope called a slit lamp to see the outer surface clearly.

Tests that may be done

• A slit-lamp examination to look at the front of the eye
• Fluorescein dye test – a harmless orange dye is placed in the eye; areas of missing surface cells glow under a blue light, showing the damage
• General eye exam to check vision and rule out other conditions

What to expect at your appointment

The examination is usually painless, though the dye test may sting slightly. You may be asked to rest your chin on a small rest while the doctor looks at your eye. The whole appointment typically takes less than 30 minutes, and you should get answers about your condition right away.

Treatment

Treatment focuses on relieving pain, preventing infection, and helping the eye heal naturally. Photokeratitis is not a condition that requires antibiotics or eye surgery unless a complication arises. Most people recover within 24 to 48 hours with simple care.

Self-care at home

• Remove contact lenses immediately if you wear them and do not put them back in until your eyes feel completely normal.
• Close your eyes and rest them in a darkened room.
• Place a clean, cool, damp cloth gently over your closed eyelids to soothe the burning sensation.
• Use lubricating eye drops (artificial tears) as directed on the package or by your pharmacist to keep the eye moist.
• Avoid rubbing your eyes, as rubbing can worsen the damage.
• Take over-the-counter pain relief only if recommended by a pharmacist or healthcare professional, following the instructions on the label.

Medical treatments

A healthcare provider may prescribe antibiotic eye drops or ointment to prevent infection, especially if the corneal damage is significant. They may also recommend prescription pain-relief eye drops or dilating drops to reduce pain and muscle spasms in the eye. Always follow the medical advice you are given, and do not use left-over eye drops from other prescriptions.

When is surgery considered?

Surgery is almost never needed for photokeratitis. It is only considered in rare cases where a severe infection leads to scarring of the cornea and permanent vision changes. For the vast majority of people, the cornea heals on its own.

Living with this condition

During the first 24 to 48 hours after symptoms start, plan to take it easy. Dim the lights, avoid screens and bright environments, and give your eyes time to heal. If you must go outside, wear dark, UV-protective sunglasses and keep your eyes closed as much as possible. Most people feel significantly better within one day.

Lifestyle tips

• Make a habit of wearing sunglasses with 100% UV protection whenever you are outdoors, even on cloudy days.
• If you work near bright lights, welding equipment, or the sun for long periods, wear appropriate safety goggles or a welding helmet.
• When skiing, climbing, or spending time on reflective surfaces, use glacier goggles or sunglasses that block UV rays from the sides.
• Remind family members, especially children, to protect their eyes too.

Diet and exercise

No special diet is needed to recover from photokeratitis, but staying well-hydrated helps your body heal. Foods rich in vitamin C and omega-3 fatty acids, like oranges and nuts, support eye health in general. Avoid vigorous exercise until your eye pain and light sensitivity have resolved, as sweating can irritate the eye.

Mental health and emotional wellbeing

Having painful, light-sensitive eyes can be distressing and may stop you from carrying out your normal routine. Temporary frustration is normal. Remind yourself that this condition is short-lived and most people recover completely within two days. If the discomfort causes anxiety or sleep problems, talk to a healthcare professional or reach out to a trusted friend or family member.

Prevention

Yes, photokeratitis is almost completely preventable. Wear UV-blocking sunglasses or clear safety glasses with UV protection whenever you are outdoors in bright light, especially around snow, water, or sand. Choose wraparound styles to block light from the sides. Use appropriate welding helmets or face shields for industrial work. Never look directly at the sun or at tanning lamps without eye protection.

Vaccines

There is no vaccine for photokeratitis. Prevention is through eye protection and limiting UV exposure.

Screening programmes

Routine eye exams can help identify conditions that may make your eyes more sensitive to light, such as dry eye or cataracts. If you have recurrent eye pain or light sensitivity, an eye care professional can review your eye protection habits and rule out other causes.

Complications

If left untreated

• Infection of the damaged cornea (microbial keratitis) if bacteria enter the eye
• Corneal ulcers – open sores on the clear surface of the eye
• Temporary or, rarely, permanent scarring of the cornea
• Persistent dry eye or light sensitivity after the acute episode resolves

Long-term outlook

The outlook is excellent. With simple self-care and if necessary professional guidance, the cornea usually repairs itself completely within one to two days. Long-term damage is extremely rare if the eyes are protected during the healing phase and if any complications are treated promptly. Following eye protection guidelines will help you enjoy sunny days without worrying about future episodes.

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