Case Reports

Photokeratitis with stromal burn: accidental exposure to ultraviolet radiation in an offset printing press in India

Case Report Details

First Author: K.Singh INDIA

Co Author(s):    D. Subramanyam                    

Abstract Details

Purpose:

Patients with Ultra Violet radiation induced photo-keratitis most commonly present with epithelial signs such as keratoepitheliopathy. We report this case of Ultra violet radiation induced photo-keratitits with rare finding of epithelial as well as stromal burn in an industrial setting.

Setting:

Patient presented to the out patient department of Vasan Eye Care, Mysore, India. He was examined, diagnosed, treated and followed up at the same place.

Report of Case:

Thirty six year old male from Mysore, Karnataka, India presented early morning to the outpatient department with chief complaint of pain,foreign body sensation,redness,watering and inability to open both eyes since morning. He was a technician in an offset printing press where he worked with ultra violet light for curing of ink in the press. He had noticed burning sensation in both his eyes one day prior while working there. On ophthalmic examination, best corrected visual acuity was 6/9 in right eye and 6/6 in left eye.Lid edema and erythema was present in both the eyes. On slit lamp examination,Circumcorneal and diffuse congestion was observed in both eyes.Corneal punctate epithelial erosions were seen in both eyes while in right eye, necrotic spot was observed in central cornea at the level of anterior stroma, suggestive of stromal burn.Anterior Chamber was quiet and lens was clear in both eyes. Posterior segment examination revealed no abnormality. Intra Ocular Pressure recorded by non-contact tonometry was 20 mmHg in right eye and 21 mmHg in left eye. Diagnosis of radiation induced photokeratitis was made based on the assumption that he was exposed to ultraviolet light while working in the printing press. The patient was started on topical preservative free tear substitute, topical antibiotic, oral analgesics and Vitamin C tablets. At 1 week follow up, his visual acuity was 6/6 in both eyes and all the symptoms and signs had remarkably improved. He was advised to continue the medication for one more week. The management at printing press was informed about the accident and ultra violet lamp was replaced to avoid another accident.

Conclusion/Take Home Message:

With the advent of technology, use of ultra violet light has also become diverse. It ranges from being used as a lamp for disinfection to disco lights in nightclubs. Consequently, Eye care professionals all over the world are likely to come across more cases of radiation induced photokeratitis in coming future. Occupational history should always be taken into account when coming across such cases. The strict enforcement of ultra violet radiation safety protocols is the need of the hour in current scenerio of exponential technological growth.

Financial Disclosure:

None