Photokeratitis

Photokeratitis is a painful, sudden sunburn of the clear front window of the eye, called the cornea. It happens when the cornea is exposed to too much ultraviolet (UV) light. You can think of it exactly like a sunburn on the skin, but it is on your eye surface. The damage mainly affects the thin outer skin of the cornea, called the corneal epithelium. Tiny cells in this layer get injured by UV energy, lose their tight connections, and peel off. That peeling exposes sensitive nerve endings. This is why the pain and light sensitivity can be severe.

Most people do not feel symptoms right away. There is a delay of about 6 to 12 hours after exposure. During this delay, chemical changes happen inside the corneal cells. These changes release inflammatory signals that trigger pain, tearing, and light sensitivity later in the day or overnight. This “late pain” pattern is a helpful clue for doctors.

Photokeratitis is usually temporary. In most healthy people, the surface cells heal within 24–72 hours. Vision typically returns to normal once the epithelium has healed. However, the hours in between can be very uncomfortable, and repeated UV injuries over years may raise the risk of other eye problems, especially pterygium and cataracts. That is why prevention with proper eye protection is essential.

How UV light harms the cornea

UV light comes in three bands:

• UVA (315–400 nm) — reaches the ground; less energetic.

• UVB (280–315 nm) — reaches the ground; more energetic and the main cause of photokeratitis.

• UVC (100–280 nm) — normally blocked by the ozone layer, but artificial UVC lamps (germicidal lamps) can expose the eyes indoors.

UVB is the main culprit. It damages the DNA and proteins in corneal cells. Injured cells release chemicals that create inflammation. The tight outer surface becomes rough and leaky. This leads to punctate epithelial erosions (many tiny surface scratches) and sometimes larger areas of peeling. The cornea has a dense network of pain nerves, so even small injuries can feel very severe.

Types of photokeratitis

Doctors sometimes use different names for the same basic problem. These labels mostly describe the source of UV light or the setting where the exposure happened.

1. Solar photokeratitis
   This is traditional sun-related exposure. It often occurs during long days outdoors without UV-protective eyewear.

2. Snow blindness
   This is solar photokeratitis in snowy areas. Fresh snow reflects up to most of the sun’s UV, so the eyes can get “double-hit” from above and below. It is common in skiers, snowboarders, mountaineers, and people in polar regions.

3. Welder’s flash (arc eye)
   Electric welding arcs produce intense UV radiation. Short, unprotected glances at an active arc can cause photokeratitis, often in both eyes.

4. Tanning-bed photokeratitis
   Tanning beds produce high UV output. Even short exposures without proper protective goggles can injure the cornea.

5. Germicidal lamp (UVC) photokeratitis
   UVC lamps are used to disinfect air and surfaces. Accidental exposure can cause photokeratitis after only minutes of unprotected viewing.

6. High-altitude photokeratitis
   The higher you go, the thinner the air, and the stronger the UV. Mountain hikers and climbers are at higher risk, especially with snow or ice around.

7. Water-surface photokeratitis
   Open water (sea, lake, pool) reflects UV light. Fishermen, sailors, surfers, and lifeguards can be affected without good sunglasses.

8. Desert/beach photokeratitis
   Bright sun, pale sand, long exposure, and wind increase risk. The combination can dry and irritate the corneal surface, worsening UV injury.

9. Occupational photokeratitis
   This refers to any job setting with significant UV exposure: welding, metal cutting, UV-curing lines, and some laboratory or hospital areas.

10. Recreational photokeratitis
    Any play or travel setting with high UV exposure: skiing, boating, mountaineering, or high-sun beach days.

11. Mild, moderate, and severe photokeratitis
    This grading refers to how much of the corneal surface is injured and how intense the pain and light sensitivity are.

12. Unilateral vs. bilateral photokeratitis
    One eye can be more affected than the other if exposure was uneven, but most cases are bilateral because both eyes were exposed at the same time.

13. No UV-blocking eyewear or the wrong eyewear (lenses that darken visible light but do not block UV are risky).

14. Long exposure time, especially midday sun.

15. High altitude, snow, ice, sand, or water reflections.

16. Cloud cover does not block UV well; people often skip protection on cloudy days.

17. Some medications or products can sensitize the skin and eyes to light (for example, certain antibiotics or retinoids).

18. Dry or windy environments that roughen the surface and reduce tear protection.

19. Past eye surface disease that already weakened the epithelium.

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Common causes

1. Direct sunlight without UV protection
   Looking toward bright sun or being outside for hours without UV-blocking eyewear lets UVB hit the cornea and burn it.

2. Snow reflection
   Snow reflects a very high amount of UV. Skiing or hiking on snow without goggles is a classic setup for “snow blindness.”

3. Welding arc exposure
   Welding arcs emit intense UV. Even a brief unprotected glance or working nearby without a shield can cause symptoms later that night.

4. Tanning beds without proper goggles
   Tanning lamps output strong UV. Ordinary sunglasses are not enough; special tanning goggles are required. Without them, the cornea burns.

5. Germicidal (UVC) lamps
   UVC is very energetic. Accidental viewing of UVC disinfecting lights, even for short periods, can burn the corneal surface.

6. High-altitude sunlight
   UV intensity rises with altitude. Climbers and trekkers who do not wear wraparound UV-blocking eyewear are at high risk.

7. Water-surface reflection
   UV reflects off oceans, lakes, and pools. Long days boating, fishing, or lifeguarding without sunglasses can cause injury.

8. Desert or beach glare
   Pale sand reflects sunlight toward the eyes. Wind dries the surface, lowering tear protection and making UV damage worse.

9. Broken or poor-quality sunglasses
   Very dark lenses without true UV protection let the pupil widen. More UV enters and burns the cornea. Always check for 100% UV labels.

10. No side protection
    UV can enter around the sides of glasses. In bright environments, wraparound or side-shield designs are safer.

11. Phototherapy lights (improper shielding)
    Some medical or industrial lights have UV output. If shields or curtains are not used, bystanders can be exposed.

12. Black-light or UV party lamps (close gaze)
    Most are lower power, but staring at them up close for long periods can irritate or injure the cornea.

13. Sunbed maintenance or lamp changing
    Workers who service UV devices can be exposed without realizing it if safety steps are skipped.

14. Indoor plant-growth UV lamps
    Certain horticulture lamps include UV. Working at short distance for long periods with no eyewear raises risk.

15. Arc flash from electrical faults
    Electrical arcs can produce UV. Accident scenes or industrial faults can lead to unprotected exposure.

16. Mountaineering in overcast conditions
    Cloud cover reduces visible light more than UV. People often remove eye protection and still receive enough UV to burn the cornea.

17. Long driving in bright snow or water areas
    Reflected UV through side windows or windshields not rated for full UV blocking can be enough over hours to injure the cornea.

18. Outdoor stadium or construction work
    Prolonged exposure at midday, especially on reflective surfaces (metal roofing, white concrete), increases UV exposure to the eyes.

19. Use of photosensitizing medications
    Some drugs make tissues more sensitive to light. While they mainly affect skin, they may also lower the eye’s tolerance to UV.

20. Not recognizing early warning signs
    Gritty sensation and mild irritation during exposure are hints to stop and protect. Continuing exposure can turn mild irritation into a full burn.

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Symptoms

1. Delayed severe eye pain
   Pain usually begins several hours after UV exposure. It may wake you from sleep.

2. Intense light sensitivity (photophobia)
   Even normal room light can feel unbearable. People often keep their eyes closed or wear sunglasses indoors.

3. Gritty or sand-in-the-eye feeling
   The rough corneal surface feels like something is stuck under the lids.

4. Tearing and watery discharge
   The eyes water heavily because the surface nerves are irritated.

5. Redness
   Blood vessels on the white of the eye (conjunctiva) swell, making the eye look red.

6. Eyelid spasm (blepharospasm)
   The lids squeeze shut without you trying. This is a natural reflex to protect the painful surface.

7. Blurred vision
   The cornea is the main focusing surface. When it is rough and swollen, the image becomes blurry.

8. Haloes around lights
   Light scattering through the rough cornea creates rings and glare.

9. Foreign-body sensation
   It may feel as if a hair or metal speck is stuck, even when nothing is there.

10. Headache
    Strain from keeping the eyes closed and from photophobia can cause headaches.

11. Swollen eyelids
    The lids can puff up from irritation and rubbing.

12. Burning or stinging
    The exposed nerve endings make the eyes feel raw or burning.

13. Difficulty opening the eyes on waking
    The first moments after sleep can be especially painful until tears coat the surface.

14. Temporary decreased vision clarity
    Reading, screen use, or recognizing faces can be hard until the surface heals.

15. Sleep disturbance
    Pain starting at night can interrupt sleep and cause significant discomfort until treated.

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Diagnostic approach

The diagnosis is mostly based on history (what you were doing) and exam (how the cornea looks with special dyes and lights). The classic story is intense UV exposure earlier that day followed by late-night pain. The most helpful exam step is putting a fluorescein dye drop in the eye and looking with a blue light. In photokeratitis, the cornea shows many tiny bright spots (punctate staining) across the exposed area. Vision returns to normal after healing in a few days. Doctors also consider other problems that can look similar and are more serious, such as herpes simplex keratitis, bacterial keratitis, corneal abrasion, uveitis, or solar retinopathy (which is a retina injury, not a cornea injury).

A) Physical exam–based tests

1. Detailed exposure history
   The doctor asks about welding, snow, beach, tanning beds, germicidal lamps, altitude, and whether you wore UV-blocking eyewear. The time delay between exposure and pain (often 6–12 hours) is a key clue pointing to photokeratitis rather than a simple scratch.

2. Visual acuity testing (eye chart)
   Reading letters on a chart measures how much vision is affected. In photokeratitis, vision is usually blurred but improves as the surface heals. Persistent poor vision suggests something else is going on and needs further checks.

3. External eye inspection (penlight exam)
   The doctor looks for redness, tearing, eyelid swelling, and squeezing. Eyelid position and blinking are assessed. The pattern of redness can help separate surface irritation from deeper inflammation.

4. Pupil and light response check
   A bright light is shone to see how the pupils react. Strong discomfort to light (photophobia) is typical. Abnormal pupil behavior could point toward internal eye issues, not just surface sunburn.

B) Manual office tests

5. Fluorescein staining with cobalt-blue illumination
   A yellow drop (fluorescein) highlights areas where the corneal surface is missing or rough. Under a blue light, damaged spots glow bright green. In photokeratitis, many tiny spots cover the exposed zone. It is the single most useful test.

6. Eyelid eversion and sweeping
   The doctor flips the upper lid to look for trapped particles that can scratch the cornea. A sterile cotton tip may gently sweep the inner lid. This rules out a foreign body, which can mimic symptoms.

7. Corneal sensitivity test (cotton wisp or esthesiometer)
   Lightly touching the cornea checks nerve sensitivity. Normal or slightly increased sensitivity fits photokeratitis. Reduced sensitivity suggests other problems, such as herpes simplex keratitis.

8. Schirmer test (tear production)
   Small paper strips placed under the eyelids measure tear volume. Dryness does not cause photokeratitis, but dryness can worsen symptoms and slow healing, so this test can guide supportive care.

C) Lab and pathological tests — rarely needed, used to rule out other diseases

9. Corneal scraping for bacterial culture
   If there is a suspicious ulcer or a large, focal white spot, a doctor may gently collect a small sample to look for infection. Photokeratitis typically shows no focal ulcer, just scattered staining.

10. HSV (herpes simplex virus) testing
    If the pattern looks like branching lines (dendrites), the doctor may swab for HSV PCR. This helps avoid missing a viral infection, which needs antiviral treatment instead of just lubrication.

11. Conjunctival impression cytology
    A tiny filter paper pressed on the eye surface can collect cells to study under a microscope. This is not routine, but it can document epithelial damage or dry-eye–related changes that aggravate symptoms.

12. Tear osmolarity measurement
    A quick sample checks saltiness of the tears. High osmolarity suggests poor tear quality. Again, not a cause of photokeratitis, but it explains why symptoms feel worse and guides lubrication plans.

D) Electrodiagnostic tests — almost never needed for typical cases, but useful for differential diagnosis

13. Visual evoked potential (VEP)
    Sensors on the scalp measure the brain’s electrical response to visual signals. If vision stays reduced after the cornea heals, VEP helps check the visual pathway. Normal VEP supports a surface-only problem.

14. Electroretinogram (ERG)
    This test measures retina function. It is useful when doctors want to exclude retinal injury, such as solar maculopathy, which can occur after sun gazing and causes persistent central vision loss.

15. Electro-oculography (EOG)
    EOG evaluates the retinal pigment epithelium. It is rarely required but can help when the story suggests deeper retinal problems instead of a corneal surface burn.

16. Blink reflex EMG
    Surface electrodes measure lid muscle responses. If eyelid spasm (blepharospasm) is extreme and out of proportion, this test can document nerve-lid reflexes, though it is not part of routine care.

E) Imaging and instrument-based tests

17. Slit-lamp biomicroscopy
    This is the standard microscope exam in eye clinics. The doctor can see the corneal surface in high detail, detect punctate epithelial erosions, check for swelling (edema), and look for any signs of infection.

18. Cobalt-blue filter assessment under the slit lamp
    With fluorescein dye in place, the cobalt-blue light makes damaged spots glow. The distribution (often diffuse over the exposed area) fits photokeratitis, different from a single sharp scratch.

19. Anterior segment optical coherence tomography (AS-OCT)
    This non-contact scanner creates cross-section images of the cornea. It can show epithelial irregularity and swelling. It is most helpful when doctors want to document changes or exclude other corneal diseases.

20. Fundus examination and macular OCT (to rule out solar retinopathy)
    If someone stared at the sun or an eclipse, the retina may be injured. A dilated fundus exam and macular OCT check for central retinal damage. These tests are normal in photokeratitis, which confirms the problem is on the surface.

Non-pharmacological treatments (therapies & other measures)

(Each item includes description, purpose, and simple mechanism.)

1. Get out of UV immediately
   Purpose: Stop ongoing injury.
   Mechanism: No more UV means the cornea can start repairing instead of taking fresh damage.

2. Dark, quiet room and sunglasses indoors if needed
   Purpose: Reduce pain from light.
   Mechanism: Less light hitting the inflamed cornea lowers the nerve signals that cause pain and squinting.

3. Cold compresses (clean cloth, cool water, 10 minutes, several times/day)
   Purpose: Soothe pain and swelling.
   Mechanism: Cold shrinks blood vessels and calms surface nerve endings.

4. Remove contact lenses immediately; do not wear until fully healed
   Purpose: Prevent friction and infection.
   Mechanism: Lenses rub the injured surface and can trap germs.

5. Preservative-free sterile eyewash (single-use vials) if debris is present
   Purpose: Gently rinse out particles (sand, dust).
   Mechanism: Sterile saline flushes the eye without chemicals that could sting.

6. Blinking and micro-breaks
   Purpose: Keep the surface moist.
   Mechanism: Each blink spreads natural tears like a protective film.

7. Humidify your air and avoid fans blowing into the eyes
   Purpose: Reduce dryness and stinging.
   Mechanism: Moist air slows tear evaporation so the cornea stays coated.

8. Hydration (water throughout the day)
   Purpose: Support natural tear production.
   Mechanism: Good body hydration helps the lacrimal glands make tears.

9. No eye rubbing
   Purpose: Avoid more surface damage.
   Mechanism: Rubbing can scrape off healing cells and worsen pain.

10. Protective eye shield at night (rigid shield, not a pressure patch)
    Purpose: Prevent accidental rubbing during sleep.
    Mechanism: A shield stops lids or bedding from scraping the cornea.

11. Moisture chamber goggles (wraparound)
    Purpose: Comfort in very dry or windy rooms.
    Mechanism: The goggles trap humidity around the eyes, easing burning.

12. UV avoidance while healing
    Purpose: Prevent re-injury.
    Mechanism: No UV exposure allows epithelial cells to regrow without new damage.

13. Balanced sleep
    Purpose: Help the body repair.
    Mechanism: During sleep, growth and repair signals rise, speeding epithelial healing.

14. Eyewear hygiene
    Purpose: Keep bacteria off the lids and lashes.
    Mechanism: Clean frames/goggles reduce the chance of secondary infection.

15. Bandage contact lens (placed by an eye doctor, not DIY)
    Purpose: Reduce pain from blinking in more severe cases.
    Mechanism: A soft lens acts like a smooth “bandage,” covering the exposed nerve endings while cells regrow.

16. Temporary punctal plugs (by a clinician)
    Purpose: Keep more natural tears on the eye.
    Mechanism: Tiny plugs in the tear drains make tears stay longer on the surface.

17. Amniotic membrane (in-office placement for difficult cases)
    Purpose: Speed epithelial healing when defects are large or slow to close.
    Mechanism: The membrane releases growth factors that calm inflammation and stimulate cell regrowth.

18. Education on safe welding and mountain/snow sports
    Purpose: Prevent future episodes.
    Mechanism: Knowing proper shields, goggle ratings, and exposure risks reduces recurrence.

19. Screen dimming and large fonts
    Purpose: Reduce squinting and headache if you must use devices.
    Mechanism: Less light and bigger text lower glare and eye strain.

20. Avoid eye patching (important “what not to do”)
    Purpose: Reduce complications.
    Mechanism: Pressure patches can trap heat and bacteria and do not help UV burns; they may delay healing.

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Drug treatments

(Each item: class, typical dose/time, purpose, mechanism, key side effects & warnings. Doses are general adult guidance; always follow your own doctor’s advice. Do not use leftover or someone else’s prescription drops.)

1. Preservative-free artificial tears (carboxymethylcellulose, hyaluronate) — Lubricant
   Dose/Time: 1–2 drops every 1–2 hours while awake, then taper as comfortable.
   Purpose: Comfort, reduce friction, support healing.
   Mechanism: Creates a smooth, protective tear film over the injured cornea.
   Side effects: Rare temporary blur. Prefer preservative-free to avoid irritation.

2. Lubricating eye ointment (petrolatum/mineral oil) — Surface protectant
   Dose/Time: 0.5–1 cm ribbon in the lower lid at bedtime; up to 3–4×/day if severe.
   Purpose: Overnight protection and pain relief.
   Mechanism: Thick coating shields nerve endings and prevents drying.
   Side effects: Temporary blurred vision after use (normal).

3. Acetaminophen (Paracetamol) — Analgesic
   Dose/Time: 500–1,000 mg every 6–8 hours (max 3,000 mg/day unless your doctor advises otherwise).
   Purpose: Pain control.
   Mechanism: Lowers pain signaling in the nervous system.
   Side effects/warnings: Avoid overdose; caution with liver disease or alcohol use.

4. Ibuprofen — Oral NSAID analgesic
   Dose/Time: 200–400 mg every 6–8 hours with food (max 1,200 mg/day OTC).
   Purpose: Pain and inflammation relief.
   Mechanism: Blocks prostaglandins that drive inflammation.
   Side effects/warnings: Upset stomach, ulcers, kidney strain; avoid if you have ulcer disease, kidney problems, or are in late pregnancy. Do not combine with other NSAIDs.

5. Naproxen — Oral NSAID analgesic
   Dose/Time: 220 mg, then 220 mg every 8–12 hours (max 660 mg/day OTC).
   Purpose/Mechanism/Warnings: Similar to ibuprofen; use only one NSAID at a time.

6. Cyclopentolate 1% — Cycloplegic (dilator) eye drop (prescription)
   Dose/Time: 1 drop 2–3×/day for 1–2 days.
   Purpose: Ease light sensitivity and deep aching from ciliary muscle spasm.
   Mechanism: Temporarily relaxes the focusing muscle and widens the pupil.
   Side effects/warnings: Blurred near vision, light sensitivity; rarely dry mouth or flushing. Do not drive until vision is safe.

7. Homatropine 2% — Cycloplegic (alternative to cyclopentolate; prescription)
   Dose/Time: 1 drop 2–3×/day for 1–3 days.
   Purpose/Mechanism/Side effects: Same as above.

8. Erythromycin 0.5% ophthalmic ointment — Topical antibiotic/lubricant
   Dose/Time: 0.5-inch ribbon 4×/day for 2–3 days.
   Purpose: Lubricates and reduces risk of infection while epithelium heals.
   Mechanism: Antibiotic action on skin flora; ointment also protects the surface.
   Side effects/warnings: Blurred vision after application.

9. Polymyxin B/Trimethoprim drops or a fluoroquinolone drop (e.g., moxifloxacin) — Topical antibiotic
   Dose/Time: 1 drop 4×/day for 2–3 days, mainly for contact-lens wearers or clear epithelial defects.
   Purpose: Prevent microbial keratitis in higher-risk eyes.
   Mechanism: Kills common corneal pathogens.
   Side effects/warnings: Stinging; rare allergy. Contact-lens wearers are at higher risk and should be examined.

10. Hypertonic saline 5% drops or ointment — Anti-edema
    Dose/Time: Drops 4–6×/day or ointment at bedtime if the cornea is water-logged.
    Purpose: Reduce corneal swelling when present.
    Mechanism: Draws fluid out of the cornea by osmosis.
    Side effects/warnings: Can sting; not needed in most cases.

Avoid at home: Topical anesthetic drops (numbing drops) and topical steroid drops unless prescribed and monitored by an eye specialist. Anesthetic drops can delay healing and cause serious corneal ulcers. Steroids can increase infection risk and slow epithelial regrowth.

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Dietary molecular supplements

(Discuss with your clinician, especially if pregnant, on blood thinners, or have chronic illness.)

1. Vitamin A (retinol/beta-carotene)
   Dose: Aim for daily intake ~700–900 mcg RAE (do not exceed 3,000 mcg RAE/day without medical advice).
   Function: Maintains healthy corneal and conjunctival surface.
   Mechanism: Supports mucin-producing cells and epithelial turnover.

2. Vitamin C
   Dose: 500 mg twice daily (common supportive dose).
   Function: Antioxidant; collagen support.
   Mechanism: Scavenges free radicals created by UV; supports stromal collagen repair.

3. Omega-3 (EPA+DHA)
   Dose: ~1,000 mg/day combined EPA+DHA.
   Function: Tear film stability; anti-inflammatory.
   Mechanism: Shifts eicosanoid balance toward pro-resolution mediators.

4. Zinc
   Dose: 8–11 mg/day (do not exceed 40 mg/day long-term).
   Function: Cofactor in antioxidant enzymes.
   Mechanism: Supports cellular repair enzymes on the ocular surface.

5. Lutein
   Dose: ~10 mg/day.
   Function: Ocular antioxidant; helps filter high-energy light.
   Mechanism: Carotenoid that neutralizes reactive oxygen species.

6. Zeaxanthin
   Dose: ~2 mg/day.
   Function/Mechanism: Works with lutein as a light-filtering antioxidant.

7. Astaxanthin
   Dose: 4–6 mg/day.
   Function: Potent antioxidant with ocular benefits reported in small studies.
   Mechanism: Quenches singlet oxygen from light exposure.

8. N-Acetylcysteine (NAC)
   Dose: 600 mg once or twice daily.
   Function: Mucin support and antioxidant.
   Mechanism: Precursor to glutathione; may reduce oxidative stress on the surface.

9. Curcumin (with piperine for absorption)
   Dose: 500–1,000 mg/day standardized extract.
   Function: Systemic anti-inflammatory support.
   Mechanism: Modulates NF-κB and other inflammatory pathways.

10. Vitamin D3
    Dose: 1,000–2,000 IU/day (adjust to levels).
    Function: Immune balance and epithelial health.
    Mechanism: Regulates inflammatory signaling that can affect tear film quality.

Supplements can support the environment for healing but do not replace proper eye care, medications, or protection from UV.

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Regenerative / biologic / immuno-modulating” therapies

(Important: these are not routine for simple photokeratitis. They are specialist-only options for unusual, slow-healing cases or recurrent epithelial problems.)

1. Autologous Serum Eye Drops (ASED) 20–50%
   Dose: 1 drop 4–8×/day (prepared from your own blood).
   Function: Epithelial trophic support.
   Mechanism: Contains natural growth factors, vitamins, and albumin that mimic healthy tears and promote cell regrowth.

2. Platelet-Rich Plasma (PRP) Eye Drops
   Dose: 1 drop 4–8×/day.
   Function: Stronger growth-factor support.
   Mechanism: Platelet granules release EGF, PDGF, and TGF-β that stimulate migration and adhesion of epithelial cells.

3. Amniotic Membrane Extract/Drop (where available)
   Dose: Per specialist protocol.
   Function: Anti-inflammatory and pro-healing signals.
   Mechanism: Bioactive matrix components down-regulate inflammatory cytokines and support epithelial stem cells.

4. Cenegermin 0.002% (recombinant human nerve growth factor)
   Dose: 1 drop every 6 hours for 8 weeks (Rx).
   Function: Used for neurotrophic keratitis; occasionally considered off-label if corneal nerves are impaired.
   Mechanism: Promotes corneal nerve regeneration and epithelial healing.

5. Topical Cyclosporine A 0.05–0.1%
   Dose: 1 drop twice daily (chronic use; not for immediate pain).
   Function: Improves tear film in chronic dry-eye patients after severe surface insults.
   Mechanism: T-cell modulation reduces surface inflammation so epithelium can stabilize.

6. Insulin or EGF eye drops (investigational/off-label in some regions)
   Dose: Specialist-directed.
   Function: Epithelial trophic effects.
   Mechanism: Stimulates cellular growth pathways to close persistent defects.

Note: “Immune boosters” are not used for photokeratitis. The goal is surface repair and protection, not stimulating the whole immune system.

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Procedures/Surgeries

(Most people never need these. They are reserved for large, non-healing defects or repeated erosions.)

1. Bandage Contact Lens placement
   Procedure: Sterile soft lens placed in clinic; frequent follow-up.
   Why: Covers exposed nerves, reduces pain, and lets cells crawl under the lens to close the defect.

2. Amniotic Membrane Transplant (PROKERA® or sutured graft)
   Procedure: A biologic membrane is applied to the cornea in clinic or OR.
   Why: Supplies growth factors and anti-inflammatory signals to speed closure.

3. Temporary Tarsorrhaphy
   Procedure: Eyelids partially sewn together for a short time.
   Why: Protects the cornea by reducing exposure and friction when blinking hurts healing.

4. Phototherapeutic Keratectomy (PTK)
   Procedure: Excimer laser polishes superficial cornea.
   Why: For chronic, recurrent erosions with surface irregularities after repeated injuries.

5. Punctal Occlusion (plugs or cautery)
   Procedure: Partially or permanently closes tear drains.
   Why: Keeps more natural tears on the eye when dryness blocks healing.

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Practical prevention steps

1. Wear UV400-rated sunglasses that block 99–100% of UVA and UVB.

2. Choose wraparound goggles for snow, water, desert, and high-altitude sports.

3. Use a wide-brim hat or helmet visor to cut overhead light.

4. For welding, use the correct shade helmet/filters and ensure side shields; never “tack” weld without full protection.

5. Avoid tanning beds and unsupervised sunlamps.

6. Check the daily UV Index; limit time outside when it’s high, especially 10 am–4 pm.

7. Be extra careful around reflective surfaces (snow, water, white sand, metal).

8. Replace scratched/old eyewear; damage reduces UV protection.

9. Use UV-blocking contact lenses only as a backup, not instead of sunglasses/goggles.

10. Educate children and new workers on UV eye safety; provide proper eyewear.

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When to see a doctor—exactly

• Severe pain, marked light sensitivity, or decreased vision at any time.

• Symptoms lasting more than 24–48 hours or getting worse instead of better.

• You wear contact lenses (higher infection risk).

• You suspect UV-C lamp exposure, chemical exposure, or a foreign body.

• Only one eye is affected, or vision is much worse in one eye.

• You accidentally used numbing drops at home (dangerous).

• Any sign of infection: pus-like discharge, spreading redness, fever.

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What to eat and what to avoid

1. Eat: Leafy greens (spinach, kale) — lutein/zeaxanthin for light-filtering antioxidants.

2. Eat: Oily fish (salmon, sardine, mackerel) — omega-3s for tear stability.

3. Eat: Citrus/berries/kiwi — vitamin C for collagen and antioxidant support.

4. Eat: Orange/yellow veggies (carrots, sweet potato) — vitamin A precursors.

5. Eat: Nuts and seeds (walnut, chia, flax) — additional omega-3 and vitamin E.

6. Avoid for a few days: Alcohol, which dehydrates and can worsen dryness.

7. Avoid: Smoking and secondhand smoke, which irritate and slow healing.

8. Avoid: Very spicy or extremely hot foods if they trigger facial flushing and tearing discomfort.

9. Avoid: Heavily air-conditioned, dry, or dusty dining environments; choose more humid seating.

10. General: Drink water regularly; good hydration supports natural tears.

Frequently asked questions

1) Is photokeratitis contagious?
No. It’s a UV injury, not an infection.

2) How long does it last?
Most people improve within 24–72 hours. Sensitivity may linger briefly.

3) Will my vision be permanently damaged?
Very unlikely if treated properly. The cornea’s surface usually fully regenerates.

4) Do I need antibiotic drops?
Not always. Doctors often use a lubricating antibiotic ointment for comfort and to reduce infection risk. Contact-lens wearers or clear surface defects may need antibiotic drops.

5) Can I use numbing drops to get through the pain?
No. Anesthetic drops for home use are dangerous. They stop healing and can cause serious ulcers.

6) Do steroid drops help?
Usually not for simple photokeratitis and may increase infection risk. Only use if an eye specialist specifically prescribes and monitors them.

7) Should I patch my eye?
No. Patches can trap heat and bacteria and don’t help UV burns.

8) When can I wear contact lenses again?
Wait until you are completely symptom-free and an eye doctor confirms the surface is healed—usually a few days.

9) Cold or warm compresses?
Cold compresses are best at first for pain and swelling.

10) Can children get photokeratitis?
Yes. Children at beaches, snowfields, or under UV lamps are vulnerable and must wear proper UV protection.

11) Can I work or drive?
If light sensitivity or blur is significant, do not drive. Rest until vision is comfortable and safe.

12) Do blue-light screen filters prevent this?
No. Photokeratitis is from UV, not blue light from screens. Blue-light filters do not block UV.

13) Is one episode a risk for future problems?
Usually no, but repeated UV injuries can contribute to other eye issues over time. Protective eyewear is key.

14) How do I pick good sunglasses?
Look for UV400 or “100% UVA/UVB” and wraparound frames. Darker lenses are not necessarily better unless rated for UV.

15) I’m at high altitude on snow—what’s the minimum protection?
Wraparound UV400 goggles (not just sunglasses) plus a brimmed hat. Reflection from snow greatly boosts UV exposure.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 21, 2025.