Electric shock-induced cataracts

A 31-year-old male electrician presented 6 months after sustaining a high-voltage electric shock injury.He had no visual complaints for the first 2 months after the injury and then began to experience progressive bilateral decreased vision, which gradually worsened over the next 4 months.His best-corrected visual acuity was 6/36 (plano) in the right eye and 6/12 (plano) in the left, with normal intraocular pressures.The slit-lamp examination revealed anterior subcortical cataracts which had the appearance of a spreading brushfire, with a clear demarcation (Figs.1a and b, white arrow) between the affected (cataractous) and unaffected lens areas.Additionally, posterior cortical changes exhibited a fern-like pattern in the right eye (Fig. 1c, yellow arrow), reminiscent of patterns seen in lightning-related injuries in skin.Fundus examinations of both eyes were unremarkable.The patient also had healed burn scars on his left hand (Fig. 1d) and other areas of his body.The eye is susceptible to damage from electric shock injuries, which can lead to protein coagulation in the lens material and lens epithelial cells. 1 This results in opacities in the cortical layer and subcapsular lens epithelial cells, typically developing within 1 to 12 months post-injury.2 Other ocular changes may include macular oedema, uveitis, miosis, optic neuritis, and retinal detachment. 1 The cataract induced by the electric shock could be treated by phacoemulsification cataract surgery combined with posterior chamber intraocular lens implantation.