Photokeratitis and Other Phototoxic Effects on the Cornea and Conjunctiva

Cullen, Anthony

doi:10.1080/10915810290169882

Cited by 132 publications

(99 citation statements)

References 20 publications

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“…CDK is associated with chronic UV-A and UV-B exposure [21]. A high prevalence has been reported in geographical areas with high levels of UV exposure [73].…”

Section: Climatic Droplet Keratopathy (Cdk)mentioning

confidence: 99%

“…Photokeratitis represents the acute corneal response to UVR exposure. It appears up to 6 hours after exposure to UVR and resolves within 8-12 h [21]. The primary response occurs in the epithelium, but the keratocytes and endothelium can also be damaged [21].…”

Section: Photokeratitismentioning

confidence: 99%

“…The cornea and the lens cortex are major UV filters and absorb primarily the shorter, more active UVB range wavelengths [20]. The human cornea absorbs all UVR below around 280 nm [21]. Above this threshold, there is a rapid increase in transmission to 320 nm, then a steady increase to a maximum in the visible spectrum.…”

Section: Ocular Effects Of Uvrmentioning

confidence: 99%

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The Role of Ultraviolet Radiation in the Ocular System of Mammals

et al. 2014

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Abstract:With decreasing levels of ozone in the atmosphere, we are being exposed to higher levels of ultraviolet radiation (UVR) than ever before. UVR carries higher energy than visible light, and its effects on tissues include DNA damage, gene mutations, immunosuppression, oxidative stress and inflammatory responses. In the eye, UVR is strongly associated with the development of basal and squamous cell carcinoma of the eyelid, pterygium, photokeratitis, climatic droplet keratopathy, ocular surface squamous neoplasia, cataracts, and uveal melanoma, and is weakly associated with age-related macular degeneration. Despite overwhelming evidence regarding the deleterious effects on UVR, public health measures to encourage UV protection of the eyes is generally lacking. Options for photoprotection include sunglasses, wide brim hats, windshields, plastic films for side windows in cars, UV blocking contact lenses, and following the UV Index report daily. The American National Standards Institute currently has regulations regarding properties of UV blocking sunglasses; however, compliance in the US is not mandatory. On the other hand, UVR does have therapeutic applications in the eye, particularly, riboflavin activated by ultraviolet A light (UVA) radiation is used clinically to slow the progression of keratoconus, post-LASIK keratectasia, and bullous keratopathy by crosslinking corneal collagen fibers. OPEN ACCESSPhotonics 2014, 1 348 Additionally, riboflavin activated by UVA has been shown to have antibacterial, antiviral, and antiparasitic effects. This is clinically relevant in the treatment of infectious keratitis. Finally, exposure to low levels of light in the UV spectrum has been found to regulate the growth of the eye and lack of adequate exposure may increase the risk of development and progression of myopia.

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“…CDK is associated with chronic UV-A and UV-B exposure [21]. A high prevalence has been reported in geographical areas with high levels of UV exposure [73].…”

Section: Climatic Droplet Keratopathy (Cdk)mentioning

confidence: 99%

Section: Photokeratitismentioning

confidence: 99%

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The Role of Ultraviolet Radiation in the Ocular System of Mammals

et al. 2014

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“…Acute UVR exposure in man can cause photokeratitis characterized by apoptosis and exfoliation of the corneal epithelium, formation of punctate ulcers, inflammation, edema, and pain (Cullen, 2002;Young, 2006). Chronic UVR exposure, on the other hand, is associated with spheroidal degeneration of the cornea, which has also been called Bietti corneal degeneration, Labrador keratopathy, Eskimo corneal degeneration, and elastotic degeneration.…”

Section: Introductionmentioning

confidence: 99%

Ultraviolet Radiation-Induced Corneal Degeneration in 129 Mice

et al. 2007

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Ultraviolet radiation (UVR) is a risk factor for the development of ocular disease in humans, including acute photokeratitis, chronic corneal spheroidal degeneration, and cataract formation. This report describes the ocular lesions seen in 21 mice chronically exposed to UVR as part of a skin carcinogenicity study. All globes were affected to varying degrees. The primary lesion, not previously reported in UVR-exposed mice, was marked loss of keratocytes relative to age-matched controls. Secondary lesions included corneal stromal thinning, keratoconus, corneal vascularization and fibrosis, keratitis, globe rupture, and phthisis bulbi. In addition, more than 90% of UVR-exposed and unexposed lenses had evidence of cataract formation; this is the first report of the occurrence of spontaneous cataracts in 129 mice. In a subsequent study, apoptotic cells were identified histologically and by cleaved caspase 3 immunoreactivity in the corneal epithelium and, less commonly, in the corneal stroma after acute UVR exposure. Based on this finding, we propose that the loss of keratocytes observed in the chronic study was due to UVR-induced apoptosis.

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“…Possible non-environmental factors or undiagnosed causes of DED were also considered as differential (for example a suspected Sjögren's syndrome was not investigated to fulfill the criteria). From this perspective, diseases that were labeled as "pollution keratoconjuncitivitis, " "computer vision syndrome, " and other environmentally related encounters, due to DED clinical presentation would be defi- (19) UV exposure Keratosis of exposed skin, burning sensation, redness, punctate keratitis Allergic keratoconjunctivitis (10) (20) Allergy History of allergy, redness, itching, swelling…”

Section: Introductionmentioning

confidence: 99%

Is dry eye an environmental disease?

Alves¹,

Novaes²,

Morraye³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Previous studies have revealed that eye contact with either air pollutants or adverse indoor and/or outdoor environmental conditions can affect tear film composition and ocular surface components. These effects are mediated by selective binding of the environmental agents to ocular surface membrane receptors, leading to activation of pro inflammatory signaling pathways. The aim of the current review was to examine the published evidence associated with environmental factors and ocular surface disease and dry eye. Specifically, the reader will appreciate why it is possible to refer to them as mediators of Environmental Dry Eye Disease (EDED), a singular clinical entity inside DED context, directly caused by pollutants and/ or adverse climatic conditions. The indicators and clinical findings are described along with EDE differential diagnosis in its acute and the chronic phases. Based on strong existing evidence of clinical reports and epidemiological observations regarding DED and environmental factors we conclude that there is a straight cause-and-effect relationship between ambient stresses and DED. International standards and web-based tools are described for monitoring worldwide environmental conditions referring localities and populations susceptible to EDED. This information is beneficial to health providers to pinpoint the individuals and predisposed groups afflicted with DED. Such insights may not only improve the understanding and treatment of DED but also help to identify the contributing factors and lower the frequency and progression of EDED. of DED has been studied and confirmed in animal models of human DED (13)(14)(15) . KeywordsAs indicated, a healthy and pain-free ocular surface depends on identifying and eliminating factors that cause ambient humidity, airflow and purity, and temperature to intolerable levels. Such an undertaking is needed to preserve tear film qualities commensurate with ocular surface health. This is essential to sustain sufficient corneal refractive power, visual acuity, and ocular comfort (5,16,17) . A desiccating environment can lead to increase in tear film evaporation and/or decline in its turn over and clearance. These initial events lead to exposure of the ocular surface to hazardous environmental elements that trigger or exacerbate EDED symptoms. Clinical findings have shown that increased numbers of people are affected by EDED because of exposure to environmental factors ( Figure 2).Our purpose herein is to provide a critical appraisal of the clinical and epidemiological evidence indicating that DED is influenced by environmental factors. Secondly, we delineate EDED as a single clinical entity with a unique set of symptoms and clinical findings different from that of either DED or other diseases, such as Sjögren's syndrome, diabetes mellitus or drug induced, allergic conjunctivitis, toxic or irritative conjunctivitis, and actinic keratitis. Moreover, we will describe standard tools used to monitor environmental conditions and discuss their relevance in EDED ep...

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Photokeratitis and Other Phototoxic Effects on the Cornea and Conjunctiva

Cited by 132 publications

References 20 publications

The Role of Ultraviolet Radiation in the Ocular System of Mammals

The Role of Ultraviolet Radiation in the Ocular System of Mammals

Ultraviolet Radiation-Induced Corneal Degeneration in 129 Mice

Is dry eye an environmental disease?

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