Cornea
UV Photokeratoconjunctivitis
Also known as: UV keratitis, photokeratoconjunctivitis, arc eye, flash burn eye, welder's flash, snow blindness, UV burn eye, sunbed eye burn
Filed as: Soon
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Painful corneal and conjunctival inflammation from excessive ultraviolet radiation exposure. Classic causes are: welding arc without eye protection (arc eye), snow-reflected UV (snow blindness), sunbed overexposure, and high-altitude UV exposure. Symptoms characteristically onset 6–12 hours after exposure — the delayed onset is a key diagnostic clue.
Recognition
Symptoms: what patients report
- Bilateral severe burning or gritty eye pain.
- Photophobia.
- Profuse tearing.
- Blepharospasm.
- Foreign-body sensation.
- Characteristic delayed onset — 6–12 hours after UV exposure (patient may have gone to bed and woken with severe symptoms).
- History: welding (not wearing goggles), sunbed use, skiing or trekking in snow without UV protection, high-altitude exposure.
Signs: what the examination shows
- Punctate epithelial erosions staining with fluorescein, bilateral — often in the exposed interpalpebral cornea, sometimes diffuse.
- Conjunctival hyperaemia and chemosis.
- Mild lid oedema.
- Corneal sensation: preserved.
- Visual acuity: mildly reduced, improves with lubrication.
- No corneal infiltrate.
- No anterior chamber activity.
What OptoGuide™ covers for uv photokeratoconjunctivitis
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked New Zealand therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Photokeratitis (UV burn, arc eye, snow blindness) — College of Optometrists CMG
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Eye Infections. Durand ML, Barshak MB, Sobrin L. The New England Journal of Medicine. 2023;389(25):2363-2375.
- Four cases of pediatric photokeratitis present to the emergency department after watching the same theater show. Mangan MS, Arici C, Atalay E, et al. Turkish Journal of Ophthalmology. 2015;45(5):226-8.
- UV-photokeratitis associated with germicidal lamps purchased during the COVID-19 pandemic. Sengillo JD, Kunkler AL, Medert C, et al. Ocular Immunology and Inflammation. 2021;29(1):76-80.
- Ultraviolet keratitis: from the pathophysiological basis to prevention and clinical management. Willmann G. High Altitude Medicine & Biology. 2015;16(4):277-82.
- Diagnosis and management of Thygeson's superficial punctate keratitis. Duszak RS. Optometry. 2007;78(7):333-8.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.