What is the treatment for UV conjunctivitis?

Treatment of UV Conjunctivitis

The treatment for UV conjunctivitis (photokeratitis) is primarily supportive care with artificial tears, cold compresses, and pain management while avoiding topical corticosteroids, as the condition is self-limited and typically resolves within 24-72 hours. 1, 2

Clinical Features of UV Conjunctivitis

• Presents with:

  • Acute onset of ocular pain
  • Tearing
  • Conjunctival chemosis (swelling)
  • Blepharospasm (eyelid spasm)
  • Deterioration of vision
  • Symptoms typically appear several hours after UV exposure
  • Duration of symptoms: up to 3 days 3

• Common scenarios for UV exposure:

  • Mountaineering
  • Skiing (snow reflection)
  • Beach activities
  • Welding without proper eye protection ("welder's flash")
  • Exposure to germicidal UV-C lamps 3, 4

Treatment Protocol

Immediate Management

1. Remove from UV source and provide eye protection

2. Supportive care:

   • Preservative-free artificial tears (every 1-2 hours)
   • Cold compresses to reduce inflammation and discomfort
   • Pain management with oral analgesics (acetaminophen or NSAIDs)
   • Rest in a dark room to reduce photophobia 2

3. Avoid topical corticosteroids as they can potentiate infections and should not be used without ophthalmology consultation 2

Follow-up

• Most cases resolve spontaneously within 24-72 hours
• If symptoms persist beyond 3 days or worsen, ophthalmology referral is indicated

Prevention Strategies

• Eye protection:

  • UV-blocking sunglasses that wrap around the face
  • Snow goggles for winter sports
  • Appropriate welding shields
  • Proper eye protection when working with UV-C germicidal lamps 5, 3

• Environmental awareness:

  • Increased risk at high altitudes where UV intensity is greater
  • Higher risk in highly reflective environments (snow, water, sand)
  • Awareness of UV index and limiting exposure during peak hours 6

Special Considerations

• Children may be more susceptible to UV damage and require particular attention to prevention 6
• Chronic exposure to UV radiation is associated with:
  • Pterygium
  • Climatic droplet keratopathy
  • Increased risk of cataracts 5

Common Pitfalls

• Delayed diagnosis due to latency between exposure and symptom onset (typically 6-12 hours)
• Misdiagnosis as infectious conjunctivitis, leading to unnecessary antibiotic use
• Inadequate pain management - UV keratitis can be extremely painful
• Inappropriate use of topical corticosteroids without ophthalmology consultation 2

UV conjunctivitis is a self-limited condition that responds well to supportive care. The corneal epithelium has remarkable regenerative capacity, allowing for complete recovery in most cases without long-term sequelae when properly managed.