From the Research
Photokeratitis treatment should prioritize supportive care, including removing the source of exposure, avoiding rubbing the eyes, and using over-the-counter analgesics like acetaminophen or ibuprofen for pain management, as the most recent and highest quality evidence does not support the use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) due to potential risks of keratitis and corneal melt 1, 2. The treatment approach for photokeratitis involves several key steps:
- Remove contact lenses if worn and avoid rubbing the eyes to prevent further irritation.
- Use over-the-counter analgesics like acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours) for pain management.
- Apply cold compresses to the closed eyelids for 5-10 minutes several times daily to reduce inflammation and discomfort.
- Use artificial tears (preservative-free) frequently, every 1-2 hours while awake, to lubricate the eye surface.
- For severe pain, a healthcare provider may prescribe cycloplegic eye drops like cyclopentolate 1% (1-2 drops 2-3 times daily) to reduce ciliary spasm and pain.
- Antibiotic drops are generally unnecessary unless there's a risk of infection.
- Patients should rest in a dark room, wear sunglasses when outdoors, and avoid further UV exposure until healing is complete, as highlighted in a study on increased photokeratitis during the COVID-19 pandemic 3. It's essential to note that while older studies suggested potential benefits of topical NSAIDs like ketorolac in treating ocular inflammatory conditions 4 or corneal abrasions 5, more recent evidence warns against their use due to adverse effects 1, 2. Therefore, the primary focus should be on supportive care and avoiding unnecessary medications that could exacerbate the condition.