fotokeratitis

Fotokeratitis, also known as corneal UV keratitis or snow blindness, is an acute inflammation of the cornea and sometimes the conjunctiva caused by ultraviolet (UV) radiation exposure. It can result from natural sun exposure, reflections from snow, water, or sand, high altitude, or artificial UV sources such as welding arcs, tanning beds, and UV lamps. The condition is often bilateral and may present rapidly after exposure.

The underlying mechanism involves UV photons damaging corneal epithelial cells, leading to superficial punctate erosions. Symptoms typically begin 6 to 12 hours after exposure and may last 24 to 72 hours. Patients commonly report sudden eye pain, a gritty or foreign-body sensation, tearing, redness, photophobia, blurred vision, and headaches. Light sensitivity can be particularly uncomfortable.

Diagnosis is mainly clinical, based on history of UV exposure and ocular symptoms. Slit-lamp examination with fluorescein staining reveals punctate epithelial defects on the cornea. Other causes of eye pain should be considered if symptoms are atypical or prolonged.

Treatment is supportive. Immediate steps include removing ongoing UV exposure and applying cool compresses and preservative-free artificial tears for lubrication. Topical antibiotics may be used to prevent secondary infection if epithelial defects are present. Analgesics are often needed for pain; cycloplegic drops may be used in more uncomfortable cases. In uncomplicated cases, vision typically returns to baseline within a few days. Severe or atypical cases require evaluation by an eye care professional; steroids are reserved for specific situations and must be supervised.

Prevention focuses on UV protection: sunglasses or goggles that block 100% UV-A and UV-B rays, wraparound styles, and avoiding tanning beds, especially during outdoor activities in bright environments. Regular use of eye protection reduces recurrence risk.