Ver el código de «Ultraviolet keratitis»

==Background==
*Also known as photokeratitis, welder's flash, snow blindness 
*Prolonged/excessive UV exposure to eyes leads to inflammatory response and subsequent desquamation of corneal epithelium leaving exposed nerve endings of cornea
*May not be initially apparent with latent period (6-12 hours) before onset 

===Causes===
*Lack of proper eye protection 
*UV exposure from:
**Natural sources: snow, water, high altitudes (less protective ozone), eclipses 
**Artificial sources: Welder's arc, tanning beds, damaged metal halide lamps/lights

{{Keratoconjunctivitis Types}}

==Clinical Features==
[[File:UVKeratitis.png|400px|thumb|Slit Lamp Exam of UV Keratitis<ref>Kwon DH, Moon JD, Park WJ, et al. Case series of keratitis in poultry abattoir workers induced by exposure to the ultraviolet disinfection lamp. Ann Occup Environ Med. 2016;28:3. Published 2016 Jan 15. doi:10.1186/s40557-015-0087-7</ref>]]
*History of recent UV exposure - symptoms typically occur 6-12 hrs after exposure (will present late night/early AM) 
*Symptoms include bilateral [[eye pain]], foreign body sensation, lacrimation, blepharospasm, photophobia, chemosis, temporary decreased [[vision loss|visual acuity]]
*[[Eye exam]] (including slit lamp)
**Surrounding eyelid and face may appear mildly erythematous and edematous (consistent with sunburn)
**Obvious tearing, discomfort, blepharospasm on exam with relief of symptoms after instilling topical anesthetic 
**Fluorescein exam - '''Superficial Punctate Keratitis''' - small, pinpoint areas of increased uptake on cornea
*Symptoms resolve spontaneously as cornea re-epithelializes over 48-72 hrs

==Differential Diagnosis==
*Other causes of [[keratoconjunctivitis]]
*Viral [[conjunctivitis]]
*Thygeson's Superficial Punctate Keratitis 
*Dry eyes

{{High altitude DDX}}

==Evaluation==
*Generally clinical diagnosis

==Management==
*[[Analgesia]] (very painful condition) - PO [[NSAIDS]], [[opioids]]. 
**Do not prescribe topical anesthetics (i.e. tetracaine) to be used at home, this can lead to poor corneal healing and corneal melt
*Eye rest (avoid re-exposure)
*Lacrilube (saline eye drops)
*± Antibiotic ointment ([[erythromycin]] ophthalmic or [[gentamicin]] ophthalmic)
*± [[Cycloplegic]]s

==Disposition==
*Discharge
**Follow up with primary care provider in 1-2 days to ensure improvement of symptoms 
**Generally do not need ophtho follow-up given limited course 
**Emphasize proper eye protection with future exposure

==See Also==
*[[High Altitude Medicine]]
*[[Eye Algorithms (Main)]]
*[[Keratoconjunctivitis]]

==References==
<References/>

[[Category:Environmental]]
[[Category:Ophthalmology]]