Treatment of Photokeratitis

Immediate Management

• The American Academy of Ophthalmology recommends prophylactic topical antibiotics, such as fluoroquinolones, for corneal abrasions to prevent progression to bacterial keratitis, with treatment initiated promptly, ideally within 24 hours of injury, to prevent corneal ulceration 1, 2
• Avoid eye patching or bandage contact lenses in photokeratitis cases, as these interventions increase the risk of secondary bacterial keratitis 1, 3

Clinical Course and Follow-up

• Patients should be instructed to return immediately if symptoms worsen, as this could indicate secondary bacterial infection 3, 4

Key Clinical Pitfalls

• The distinction between photokeratitis and bacterial keratitis is critical, with photokeratitis presenting with bilateral punctate epithelial erosions limited to the palpebral fissure zone after known UV exposure, whereas bacterial keratitis typically presents with unilateral infiltrate and suppuration 5