1 Epidemiology Of

Photokeratitis
ATTAAH SELASE OSIRIS, 2486814
2 Contents

Introduction
Aetiology
Sign and symptoms
Diagnosis
Epidemiology
Treatment, Mangement, Prevention
3 Photokeratitis

An acute self limiting inflammation of the cornea by

prolong exposure of insufficiently protected eyes to UV
rays. (medscape, n.d)
Latent period of about 6-12 hrs before symptoms.
Other names : snow blindness, niphablepsia, arc eye,
welder’s flash, photopthalmia.
4 Aetiology

The threshold for acute UV photokeratitis is found at a

peak sensitivity of 270 nm(Hwai-Tan, 2012).
200 seconds of unattenuated exposure to UVB may
results in photokeratitis . (La Moore et al, 2010)
Artificial UVC radiation (such as from commercial
mercury arc lamps or germicidal lamps) can cause
photokeratitis. (Bridgette et al, n.d)
Absorption - toxicity - apoptosis.
5 Sources of UV radiation
 Natural sources : sun,
snow and water
reflections, lightning.
 Artifical sources : metallic
halide bulbs, welding
arcs, Tanning beds
6 Signs and symptoms
Signs Symptoms

Bilateral Irritation and foreign body

Lid chemosis and sensation
redness Pain
Conjunctival hyperaemia photophobia
Mild transitory visual blepharospasm
loss lacrimation
blurring of vision
7 Diagnosis

A good case history

including recent
activities.
Fluorescein staining
shows superficial
punctate keratitis.
8 Risk factors

Gender ; no difference in incidence is observed

between males and females. (medscape, 2017)
Geographical setting; higher altitudes, along beaches,
polar regions and the equator
Occupation. Eg welders, DJ’s, fishermen
Lifestyle
 EPIDERMIOLOGICAL STUDY ON PHOTOKERATITIS
9 ASSOCIATED WITH DAMAGED METAL HALIDE BULBS AND
UV-RADIATION BURNS (Finn et al, 2013)

 Participants: A total of 273 persons potentially exposed during events

in 3 gymnasiums in the United States.
 Results:18 persons met the case definition for photokeratitis indicating
a prevalence of approximately 7%.
 Among 37 persons sitting in this high-risk area, attack rate was 46% (17
persons).
 Only 1 (9%) of 11 persons wearing glasses or contact lenses with UV-
radiation protection in the high-risk area developed photokeratitis.
(Prevalence = 0.1)
 Awareness of occupational hazards and utilization
10 of safety measures among welders in Kaduna
metropolis, northern Nigeria (Sabitu et al, 2009)
 Radiation Related Eye Diseases among Welders of
11 Suame in The Kumasi Metropolis. (Kumah et al, 2011)
12 Cont..
 From the records, the prevalence of photokeratitis among the
Welders in Suame, Kumasi was 3.2%
 Also, There is a positive association between the exposure to
UV in welding and photokeratitis since there is no one affected
in the control group(non welders)as opposed to those
(3.2%)affected in the test group.
 In the United States UV keratitis and UV keratoconjunctivitis are
the only radiant exposure conditions of the cornea that occur
with any significant frequency in the United States (Collier et al,
2014).
13 Management/Treatment

Self limiting (24-72 hrs)

 Anesthetic eye drops to reduce pain but not used for
continued treatment.
Topical and systemic NSAIDS.
Oral analgesics.
14 Prevention

 UV exposure avoidance
 Using glasses, lenses or eye
protection that absorbs
most UV rays.
 Welders can protect their
eyes with welding helmets
and goggles.
 Use of hats and umbrellas
during sunny days.
15 References
 https://emedicine.medscape.com/article/799025-overview/
 http://www.pointsdevue.com/article/ultraviolet-damage-cornea-tropics
 Finn LE, Gutowski J, Alles S, et al. Photokeratitis Linked to Metal Halide Bulbs in
Two Gymnasiums - Philadelphia, Pennsylvania, 2011 and 2013. MMWR Morb
Mortal Wkly Rep 2016; 65:282.Bergmanson, J.P.G. (1990) “Corneal damage in
photokeratitis - why is it so painful?” OVS; 67:407 – 413
 Moore viewer LA, Hussey M, et al. Review of photokeratitis: Corneal response to
ultraviolet radiation (UVR) exposure. S Afr Optom 2010, 69(3), 123-131
 Collier SA, Gronostaj MP, MacGurn AK, Cope JR, Awsumb KL, Yoder JS, et al.
Estimated burden of keratitis--United States, 2010. MMWR Morb Mortal Wkly Rep.
2014 Nov 14. 63 (45):1027-30.
 Kumah B, Cobbina F, Duodu Dj, et al. Radiation Related Eye Diseases among
Welders of Suame in The Kumasi Metropolis. Journal of Science and Technology.
Vol.31, No. 1 (2011), pp 37.