Improper use of germicidal range ultraviolet lamp for household disinfection leading to phototoxicity in COVID-19 suspects.

Leung, Kai Ching Peter; Ko, Tak Chuen Simon

PURPOSE To report germicidal range ultraviolet (UV) irradiation-induced phototoxicity due to unprotected exposure to UV lamps for presumed household disinfection of SARS-CoV-2 in a domestic setting. METHODS We report on a family of three adults who experienced photophobia, intense eye pain, epiphora, blurred vision, and burning sensation over the face and neck area after a short period of unprotected exposure to UV germicidal lamps. RESULTS Initial examination revealed erythema and tenderness over the face and neck area, reduced visual acuity of 6/12, and conjunctival injections bilaterally in all three patients. Further assessment at the ophthalmology department three days later revealed gradual improvement of visual acuity to 6/6 bilaterally. Slit-lamp examinations revealed few punctate epithelial erosions. Fundal examinations were normal without evidence of solar retinopathy. The patients were diagnosed with germicidal-range UV irradiation-induced photokeratitis and epidermal phototoxicity. Lubricants and emollients were prescribed for symptom relief, and the patients were warned against using a UV germicidal lamp for disinfection purposes without appropriate protection. CONCLUSIONS Although SARS-CoV-2 is structurally akin to SARS-CoV-1 and MERS-CoV, and previous studies demonstrated high levels of inactivation of beta-coronavirus with germicidal-range UV, evidence for its efficacy to inactivate SARS-CoV-2 is lacking. This case report serves to emphasize the potential consequences of phototoxicity from improper use of UV germicidal lamps for household disinfection as well as to highlight the fact that UV germicidal lamps currently have no established role in household disinfection of SARS-CoV-2.