Photokeratitis is the formal term for what is commonly described as a sunburn of the eyes. This temporary and painful condition results from acute exposure to intense ultraviolet (UV) radiation. The damage affects the surface of the eye, specifically the cornea and conjunctiva, and is often likened to a skin sunburn. The condition typically affects both eyes simultaneously and can occur without the person immediately realizing the overexposure has taken place.
How UV Light Damages the Eye
The damage occurs when the eye’s outer layer absorbs excessive amounts of UVB radiation, and sometimes UVC radiation from artificial sources. Photokeratitis is characterized by injury to the corneal epithelial layer, the delicate, clear, dome-shaped surface at the front of the eye. This layer absorbs the UV energy, triggering cellular damage that results in the superficial cells dying off.
This process of cellular death exposes the underlying corneal nerve endings, which directly causes the intense discomfort. Common sources of intense UV exposure include light reflected off snow (“snow blindness”) or bright flashes from arc welding (“welder’s flash”). Tanning beds and sunlamps are also frequent causes of this ocular injury.
Recognizing the Symptoms
The sensory experience of a sunburned eye is distinct because symptoms do not begin immediately after exposure. The onset is typically delayed, appearing anywhere from 6 to 12 hours after the damaging UV radiation incident. The most characteristic sensation is an intense, gritty feeling, as though sand or a foreign body is lodged beneath the eyelids.
This foreign body sensation quickly escalates into significant, aching pain in the eyes and surrounding orbital area. The pain is often accompanied by extreme light sensitivity, called photophobia, which makes bright environments unbearable. Excessive tearing (lacrimation) is also a pronounced symptom as the eyes attempt to wash away the irritant.
The eye will appear noticeably red due to the inflammation of the conjunctiva and cornea. Other symptoms may include involuntary twitching of the eyelids (blepharospasm) and visual disturbances like blurred vision or seeing halos around lights. The intensity of these symptoms usually peaks around 24 hours after the onset.
Immediate Care and Recovery
Immediate self-care focuses on providing symptomatic relief while the superficial corneal cells regenerate. The first step is to promptly remove any contact lenses, as they can trap irritants and interfere with healing. It is important to rest the eyes by remaining indoors, preferably in a dark or dimly lit room, to minimize the pain caused by light sensitivity.
Applying a cool, damp washcloth or compress gently over the closed eyelids can help reduce inflammation and provide relief from the burning sensation. Over-the-counter oral pain relievers, such as ibuprofen or acetaminophen, can manage the discomfort. Lubricating eye drops, specifically preservative-free artificial tears, should be used frequently to moisten the compromised corneal surface.
Preservative-free drops are recommended because preservatives can irritate the already damaged epithelial layer, potentially slowing healing. Photokeratitis is a temporary condition, and the corneal epithelium is highly regenerative. Most cases resolve completely within 24 to 48 hours without any lasting damage to vision.
When to Consult an Eye Doctor
While the condition is typically temporary, certain red flags indicate the need for professional medical evaluation. A doctor should be consulted if the pain is severe, worsens after the first day, or if symptoms fail to improve after 48 hours of self-care. Persistent pain or discomfort beyond this typical recovery window may suggest a more extensive injury or complication.
Any lasting change in vision, such as persistent blurring or a decrease in visual acuity, requires an immediate eye examination. The presence of any discharge from the eye, particularly thick or colored fluid, is a significant warning sign. Discharge can indicate a secondary bacterial infection that needs specific antibiotic treatment.