{
  "schema_version": 1,
  "kind": "condition",
  "id": "photokeratitis-snow-blindness",
  "name": "Photokeratitis (welder's flash, snow blindness)",
  "category": "acute",
  "sources": "Exocin 3 mg/ml Eye Drops SmPC section 4.2 (eMC product 1353) · Hypromellose Eye Drops BP SmPC sections 4.1-4.4 (eMC product 457) · Hyde MR, Fu L, Gurnani B. Corneal Trauma: Evaluation and Management of Ocular Surface Injuries. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2026 Jul 5. Bookshelf ID: NBK459283; PMID: 29083785.",
  "review_status": "reviewed",
  "verified_against": "Hypromellose Eye Drops BP SmPC sections 4.1-4.4 (eMC product 457) · Exocin 3 mg/ml Eye Drops SmPC section 4.2 (eMC product 1353)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1410,
      "generic": "Hypromellose",
      "line": 1,
      "is_adjunct": false,
      "form": "eye",
      "strength_mg": null,
      "adult_dose": "Instil 1-2 drops into affected eye(s) three times daily as needed",
      "adult_duration": null,
      "dose_source": "Hypromellose Eye Drops BP SmPC sections 4.1-4.4 (eMC product 457)",
      "rationale": "Ultraviolet light strips the corneal epithelium over a wide area, and the pain comes from exposed nerve endings. Lubrication is what makes the eye bearable while the epithelium regrows, which it does reliably within one to three days.",
      "cautions": [
        "NEVER prescribe topical anesthetic drops (tetracaine/benoxinate) for outpatient home use (causes rapid corneal melting and permanent blindness).",
        "The symptoms start 6 to 12 hours after the exposure, so the patient was fine at the time and is now in severe pain at night. That delay is the diagnosis.",
        "Remove contact lenses and leave them out until the eye is white and comfortable.",
        "Take the lids off and look, with fluorescein if you have it. A single sharp-edged defect is an abrasion or a foreign body, not a diffuse UV burn.",
        "If vision is still reduced, or pain persists beyond 48-72 hours, this is not simple photokeratitis - refer.",
        "Oral paracetamol or an NSAID at standard doses is what controls the pain. Firm reassurance that it resolves in a day or two is part of the treatment.",
        "Ask what eye protection was worn, and about the other eye and the other workers. This is an occupational injury that repeats."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "The same drop at any age. In a child, ask how the exposure happened - watching welding without a shield is the usual story, and the other children who were watching should be asked about too.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "HYDROBLEND 0.32% EYE DROPS 10*0.5 ML SDU",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLOBAL ADVANCED PHARMACEUTICALS (GAP) > MONOPHARMA PHARMACEUTICALS",
          "price_egp": 15.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "GENTEAL EYE DROPS 10 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "NOVARTIS > NOVARTIS SCIENTIFIC OFFICE",
          "price_egp": 18.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OPTILUBRIC 0.32% EYE DROPS 30*0.5 ML SDU",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EVA PHARMA",
          "price_egp": 96.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "HYDROBLEND 0.32% EYE DROPS 30*0.5 ML SDU",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLOBAL ADVANCED PHARMACEUTICALS (GAP) > MONOPHARMA PHARMACEUTICALS",
          "price_egp": 108.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "photokeratitis-snow-blindness"
    },
    {
      "id": 1411,
      "generic": "Ofloxacin",
      "line": 1,
      "is_adjunct": true,
      "form": "eye",
      "strength_mg": null,
      "adult_dose": "1-2 drops into the affected eye every 2-4 hours for the first 2 days, then 4 times daily. Never longer than 10 days.",
      "adult_duration": "Up to 10 days",
      "dose_source": "Exocin 3 mg/ml Eye Drops SmPC section 4.2 (eMC product 1353)",
      "rationale": "A broad epithelial defect is an open door to bacterial keratitis, and a quinolone drop covers Pseudomonas, which is the organism that destroys a cornea fastest. This is prophylaxis while the surface closes - the same practice the corneal abrasion entry follows.",
      "cautions": [
        "A contact lens wearer with a corneal defect must have Pseudomonas cover and must not wear lenses until 24 hours after the surface has fully healed.",
        "Do not exceed 10 days, and do not keep the bottle for the next episode.",
        "A white spot or opacity on the cornea is keratitis, not a burn - that is a same-day ophthalmology referral, not another drop.",
        "Never inject an ophthalmic solution into the eye.",
        "Use with caution in patients with corneal epithelial defects or corneal ulcers due to the risk of corneal perforation.",
        "Avoid sun or UV exposure during use due to potential photosensitivity."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "For children 1 year and older: 1-2 drops in affected eye(s) every 2-4 hours for the first 2 days, then 4 times daily (max 10 days). Safety and effectiveness in infants below 1 year have not been established.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": [
        {
          "label": "1 year and over",
          "age_min_months": 12,
          "age_max_months": 216,
          "dose_text": "1 to 2 drops in the affected eye(s) every 2 to 4 hours for the first 2 days, then 4 times daily; maximum 10 days"
        }
      ],
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "QUIFLURO 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHAROPHARMA",
          "price_egp": 6.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OFLOXIN 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA",
          "price_egp": 7.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OFLOXACIN 0.3% EYE DROPS 10 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA TEC",
          "price_egp": 7.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OFLICIN 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 8.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OFLOSWIX 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CHEMIPHARM",
          "price_egp": 12.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OCUFLOX 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ALEXANDRIA",
          "price_egp": 19.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OPTIFLOX 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "JAMJOOM PHARMACEUTICALS-K.S.A > JAMJOOM PHARMA",
          "price_egp": 19.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OFLOX 0.3% EYE DROPS 5 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ALLERGAN > SOFICOPHARM",
          "price_egp": 20.4,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "photokeratitis-snow-blindness"
    }
  ]
}