Increased photokeratitis during the coronavirus disease 2019 pandemic

Abstract

An increased incidence of photokeratitis has occurred during the coronavirus disease 2019 (COVID-19) pandemic due to improper and unprotected use of ultraviolet lamps. Here, we summarize the clinical and epidemiological features of this increased incidence of photokeratitis and share advice in using health education to prevent it. We collected data from patients diagnosed with photokeratitis from October 7, 2019 to December 1, 2019, and from February 17, 2020 to April 12, 2020, and compared the frequency of onset, site of ultraviolet radiation (UVR) exposure, reason for exposure, exposure time, and recovery time. We also implemented and evaluated multiple measures of public health education to prevent increased disease. After the COVID-19 outbreak, the frequency of onset of photokeratitis increased significantly, especially among young women. The main reason for UVR exposure changed from welding to disinfection. The incidence sites varied, and the exposure time was longer. As a result, patients needed a longer time to recover. Positive health education was an useful and convenient measure to prevent the disease. While the COVID-19 pandemic is ongoing, more attention should be paid to public health and implement positive measures to prevent photokeratitis.

Self‐reported Side‐effects ofUltraviolet‐CDisinfection Devices

“…Nearly half of respondents who owned a lamp experienced a side-effect (48%, n = 19), which is consistent with existing research that has reported side-effects after exposure to UV-C (12,14,15). One reason these devices could be associated with adverse side-effects is because of generally higher irradiance and that the access to direct UV exposure of skin and eye are not prevented by design consideration, that is they are free-standing open sources, unlike other device types.…”

“…However, the relative benefit of using portable UV-C devices to reduce the risk of COVID-19 transmission in individual settings, compared to other mitigation measures, is still unknown (8). Moreover, despite the potential benefit of virus inactivation (9), case studies report that excessive UV-C exposure to the eyes and skin can lead to side-effects, namely eye pain (photokeratitis) and skin rash (erythema), in the workplace (10)(11)(12)(13)(14), home (12,15) school (16)(17)(18) and clinical settings (19,20). The extent to which ultraviolet radiation may induce these side-effects is dependent on the wavelength of UV radiation, the dose of UV radiation and the susceptibility of the individual (7,21,22).…”