eMedicine Specialties > Emergency Medicine > Ophthalmology

Ultraviolet Keratitis: Follow-up

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

Follow-up

Further Outpatient Care

  • Follow-up care with an ophthalmologist usually is not necessary except in cases of extensive corneal damage or in patients with preexisting serious eye conditions.

Complications

  • Superinfection, rarely
  • Vision loss, rarely

Prognosis

  • Excellent for full recovery in 24-76 hours

Patient Education

  • Educate patients about proper eye precautions, such as the use of UV-filtering lenses or limiting exposure to the sun.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Corneal Flash Burns.

Miscellaneous

Medicolegal Pitfalls

  • Do not discharge the patient with UV keratitis from the ED with anesthetized eye drops for pain control. The anesthetic eye is vulnerable to subsequent ulcer formation and secondary traumatic injuries, eg, unnoticed foreign bodies or vigorous eye rubbing. Repeated use of anesthetic drops may retard epithelial healing.
  • Document whether contact lenses were worn at the time of injury.
  • Document whether protective eyewear was worn at the time of injury. Many workmen's compensation forms require this documentation, and the information often is important for workplace safety education programs.
  • Always look for and document that you assessed the presence of foreign bodies in the eye. The diagnosis of UV keratitis does not preclude a comorbid ocular condition such as the presence of a foreign body.
  • Cases of UV keratitis that involve extensive corneal injury merit follow-up care with an ophthalmologist in 24-48 hours. Follow-up care also is recommended for patients who have persistent pain or vision deficits 48 hours after injury.
  • Never treat UV keratitis with steroids; the outcome may be disastrous if a concomitant herpetic ocular lesion is present.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous editor, Craig Feied, MD, to the development and writing of this article.



More on Ultraviolet Keratitis

Overview: Ultraviolet Keratitis
Differential Diagnoses & Workup: Ultraviolet Keratitis
Treatment & Medication: Ultraviolet Keratitis
Follow-up: Ultraviolet Keratitis
Multimedia: Ultraviolet Keratitis
References
[ CLOSE WINDOW ]

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].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

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 

[ CLOSE WINDOW ]

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

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.