welder flash burns - UV keratopathy (photo keratitis)

see also:

• ophthalmology
• chemical injuries and burns to the eyes
• ultraviolet light exposure (UV)
• RCH guideline - the acute red eye

• Vic DHS - Eye injury - Flash burns (pdf)
• Vic DHS - Eye injury - Foreign body (pdf)

• exposure to UV radiation (wavelengths 295-400nm) can result in delayed onset painful eyes due to UV keratopathy

• bilateral severe eye pain with watery eyes, photophobia and blurred vision
• commences 6-12 hours after exposure and thus commonly presents to ED overnight

• diffuse punctate epithelial erosions in the interpalpebral distribution
• usually have conjunctival injection and mild corneal oedema and AC reaction

• unilateral painful eye is unlikely to be UV keratopathy - consider other causes
• exclude FB on corneal or subtarsal
• consider chemical injuries and burns to the eyes - if in doubt, check pH

• chloramphenicol eye drops qid for 4 days
• ocular lubricants
• ice pack covered with cloth
• oral analgesics
• no eye pad needed or helpful
• most will resolve within 72hrs - if not resolving then ensure patient seeks re-assessment