eMedicine Specialties > Emergency Medicine > Ophthalmology

Ultraviolet Keratitis: Differential Diagnoses & Workup

Author: Reed Brozen, MD, Director of Air Transport, Associate Professor, Department of Emergency Medicine, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center
Coauthor(s): Christian Fromm, MD, FAAEM, FACEP, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Director of Research, Attending Physician, Department of Emergency Medicine, Maimonides Medical Center
Contributor Information and Disclosures

Updated: Feb 4, 2008

Differential Diagnoses

Conjunctivitis
Corneal Ulceration and Ulcerative Keratitis
Iritis and Uveitis

Other Problems to Be Considered

Dry eye syndrome - Poor tear lake or a decreased tear break-up time
Blepharitis - Erythema, telangiectasias, and crusting of the eyelid margins
Trauma - Can occur from relatively mild trauma, such as chronic eye rubbing
Exposure keratopathy - Poor eyelid closure with failure to cover the entire globe
Topical drug toxicity - Neomycin, tobramycin, or drops with preservatives, including artificial tears
Contact lens–related disorder - Chemical toxicity, tight-lens syndrome, contact lens overwearing syndrome, or giant papillary conjunctivitis
Thygeson SPK - Bilateral, recurrent SPK without conjunctival injection
Foreign body under the upper eyelid - Typically linear SPK with fine scratches arranged vertically
Trichiasis and/or distichiasis - Eyelashes rubbing on the cornea
Entropion or ectropion - superior or inferior SPK
Floppy lid syndrome - Extremely loose lids that pull away from the eye very easily
Associated retinopathy - Sun-gazer retinopathy associated with UV keratitis, seen particularly in psychiatric patients who stare directly into the sun

Workup

Procedures

  • Perform standard slit lamp examination with fluorescein.

More on Ultraviolet Keratitis

Overview: Ultraviolet Keratitis
Differential Diagnoses & Workup: Ultraviolet Keratitis
Treatment & Medication: Ultraviolet Keratitis
Follow-up: Ultraviolet Keratitis
Multimedia: Ultraviolet Keratitis
References

References

  1. Belin MW, Catalano RA, Scott JL. Burns of the eye. In: Catalano RA, ed. Ocular Emergencies. Philadelphia, Pa: WB Saunders Co; 1992:192-4.

  2. Brown MD, Cordell WH, Gee AS. Do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing?. Ann Emerg Med. Oct 1999;34(4 Pt 1):526-34. [Medline].

  3. Brunette DD, Ghezzi K, Renner GS. Ophthalmologic disorders. In: Rosen P, Barkin R, eds. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, Mo: Mosby Year Book; 1998:2704.

  4. Crumpton KL, Shockley LW. Ocular trauma: a quick illustrated guide to treatment, triage, and medicolegal implications. Emerg Med Rep. 1997;18:223-34.

  5. Daxecker F, Blumthaler M, Ambach W. Ultraviolet exposure of cornea from sunbeds. Lancet. Sep 24 1994;344(8926):886. [Medline].

  6. Schein OD. Phototoxicity and the cornea. J Natl Med Assoc. Jul 1992;84(7):579-83. [Medline].

  7. Spencer WH. The Cornea. Ophthalmic Pathology. 4th ed. Philadelphia, Pa: WB Saunders Co; 1996:233-35.

  8. Weaver CS, Terrell KM. Evidence-based emergency medicine. Update: do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing?. Ann Emerg Med. Jan 2003;41(1):134-40. [Medline].

  9. Wittenberg S. Solar radiation and the eye: a review of knowledge relevant to eye care. Am J Optom Physiol Opt. Aug 1986;63(8):676-89. [Medline].

  10. Yen YL, Lin HL, Lin HJ, et al. Photokeratoconjunctivitis caused by different light sources. Am J Emerg Med. Nov 2004;22(7):511-5. [Medline].

Further Reading

Keywords

actinic keratitis, snow blindness, flash burn, welder's flash, arc eye, ultraviolet keratitis, UV keratitis, UV radiation injury, corneal damage, corneal abrasion, corneal ulceration, corneal laceration, superficial punctate keratitis, SPK, UV keratoconjunctivitis, ultraviolet keratoconjunctivitis 

Contributor Information and Disclosures

Author

Reed Brozen, MD, Director of Air Transport, Associate Professor, Department of Emergency Medicine, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center
Reed Brozen, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, New Hampshire Medical Society, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Christian Fromm, MD, FAAEM, FACEP, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Director of Research, Attending Physician, Department of Emergency Medicine, Maimonides Medical Center
Christian Fromm, MD, FAAEM, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Eric M Kardon, MD, FACEP, Attending Emergency Physician, Georgia Emergency Medicine Specialists; Physician, Division of Emergency Medicine, Athens Regional Medical Center
Eric M Kardon, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

James Steven Walker, DO, MS, Clinical Professor of Surgery, Department of Surgery, University of Oklahoma Health Sciences Center
James Steven Walker, DO, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, and American Osteopathic Association
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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