A flash burn is an injury resulting from sudden, intense exposure to high-energy light or concentrated thermal energy. Sources often include arc flashes, industrial explosions, or high-intensity ultraviolet (UV) light, which can damage both the skin and the delicate tissues of the eye. The visual appearance of the damage corresponds directly to the depth of tissue penetration, similar to other burns. Understanding these distinct visual signs is important for proper assessment and care.
Visual Signs of Skin Flash Burns
The appearance of a skin flash burn is determined by the intensity and duration of the exposure, which dictates the burn’s depth. A first-degree burn, the most superficial type, affects only the outermost layer of skin (the epidermis). Visually, this presents as mild redness (erythema), often accompanied by slight swelling and dry skin, without blisters.
When the energy penetrates deeper into the second layer of skin (the dermis), it results in a second-degree burn, which has a wet or shiny appearance. A hallmark sign is the formation of blisters, which may be intact, clear, or weeping fluid. The underlying skin often looks deeply red or mottled.
A third-degree burn involves full-thickness damage, destroying all layers of the skin and often the underlying tissue. The visual presentation is markedly different, appearing leathery, white, or charred black. These severe burns are often painless because the nerve endings responsible for sensation have been destroyed.
Recognizing Ocular Flash Burns (Photokeratitis)
An ocular flash burn, medically termed photokeratitis, is a sunburn affecting the eye’s surface (the cornea and conjunctiva). It is often called “welder’s flash” or “snow blindness.” Symptoms commonly have a delayed onset, appearing six to twelve hours after the initial UV exposure.
Once symptoms manifest, the eyes exhibit pronounced redness in the white part of the eye (conjunctival injection), along with swollen eyelids (edema). Patients often report an intense foreign body sensation, describing a feeling of “sand” or “grittiness.” Excessive tearing (lacrimation) is also visible as the eye attempts to flush out damaged surface cells.
The eyes become extremely sensitive to light, a condition called photophobia, making it difficult to open them in moderately lit environments. Temporary blurred vision is also common, reflecting damage to the smooth corneal surface. These signs represent the peak of the injury before the rapid healing process begins.
Assessing Severity and Healing Timeline
The healing timeline for skin flash burns is directly related to the depth of the injury. Superficial first-degree burns resolve quickly, with redness fading and skin peeling within a week without scarring. Second-degree burns require a longer recovery, showing peeling and potential scabbing as new skin regenerates underneath.
The healing process for second-degree burns can take several weeks, requiring monitoring for signs of infection like increased pain or spreading red streaks. Third-degree burns do not heal on their own because the entire skin structure is destroyed. They maintain a dry, non-healing appearance that requires medical intervention, such as skin grafting.
Photokeratitis follows a rapid recovery course compared to skin burns. Symptoms usually peak within the first 24 hours but resolve visually and symptomatically within 48 hours as the corneal epithelium quickly regenerates. Persistence of severe pain, worsening vision loss, or a persistent cloudy appearance in the cornea are indicators that necessitate immediate medical evaluation.