Four Cases of Pediatric Photokeratitis Present to the Emergency Department After Watching the Same Theater Show

Abstract

We report four consecutive cases of photokeratitis that presented to the emergency department, interestingly after having watched the same theatre performance in the same school. The patients' ages (3 male, 1 female) ranged from 9 to 13 years. All patients presented with similar complaints consisting of pain, tearing, foreign body sensation, photophobia and blurred vision in both eyes. Patients reported watching a theatre performance in the same school approximately 4 hours before symptom onset. On slit-lamp examination, conjunctival injection and corneal punctate epithelial erosions were observed in the interpalpebral zone in both eyes. On fundus examination, no pathology was observed in the vitreous, posterior pole or peripheral retina. All cases were treated with topical antibiotics and lubricant eye drops. Corneas were clear two days later in the control visit. In this case report, exposure to ultraviolet light from high-power lamps used in the theatre was proposed as a possible cause of corneal epithelial cell damage and subsequent photokeratitis.

Keywords: Cornea; Photokeratitis; ultraviolet.

Figure 1. A photograph of the anterior segment showing severe punctate erosion of the corneal epithelium and conjunctival injection

Figure 2. A photograph of the anterior segment under cobalt-blue light after staining with fluorescein showing corneal epithelial erosion, especially in the interpalpebral zone