Topical antibiotic ointments such as erythromycin ointment can provide improved comfort and also may also prevent a bacterial super-infection. We recommend dosing erythromycin ointment 4 times a day for 2-3 days.
The use of topical NSAID drops such as ketorolac or diclofenac for pain relief remains controversial. A Cochrane systematic review in 2017 was unable to show clear benefit in topical NSAID use for traumatic corneal abrasions, and these drops are not as cost effective as oral analgesics. Thus, we do not recommend the routine use of topical NSAIDs in most cases of photokeratitis.
Patching the eye has been shown to not be effective in the treatment of corneal abrasions, and can delay corneal healing, and is thus not recommended.
Usage of cycloplegics/mydriatics such as cyclopentolate or homatropine have not been shown to be effect in corneal abrasions, and are generally not recommended.
Symptoms often delayed (6-12 hours) - pain, photophobia, prominent tearing, conjunctival infection, blepharospasm.
oral analgesia (may need opioids) and topical cycloplegia (e.g. 1% cyclopentolate) for comfort for up to about 3 days.
Treat similar to corneal abrasions with topical antibiotics and consider topical anesthetics if injury <24 hours old
bulbar conjunctival (the covering of the white part of the eye) injection and chemosis with sparing of the palpebral conjunctiva since it is blocked by the eyelids. punctate keratitis on Fluorescein stain!
Ultraviolet (UV) keratitis is known by various names, including photokeratitis, snow blindness, arc eye, and welder’s flash. These all represent the same pathology: corneal damage due to acute ultraviolet radiation exposure
Analgesia (very painful condition) - PO NSAIDS, opioids.
Do not prescribe topical anesthetics (i.e. tetracaine) to be used at home, this can lead to poor corneal healing and corneal melt.
Eye rest (avoid re-exposure).
Lacrilube (saline eye drops).
± Antibiotic ointment (erythromycin ophthalmic or gentamicin ophthalmic)