Electric cataract: a case report and review of the literature

Electrical injury and the long-term risk of cataract: A prospective matched cohort study

PURPOSE

Over the years, many cases of electric cataract related to severe electrical injuries have been reported. Most have been cases where the entrance or exit point of the current was on the skull or near the eyes. Still, cases of cataract have been reported where an electric current has passed through the body between two contact points remote from the eyes. This study investigates whether persons exposed to an electric current develop cataracts in the subsequent years.

METHODS

We identified 14 112 persons who had received electrical injuries in two Danish registries. We matched these with patients partly with dislocation/sprain injuries and partly with persons from the workforce from the same occupation using year of accident, sex and age as matching variables in a prospective, matched-cohort design. We identified cataract as outcome (DH25, DH26 and DH28) in the Danish National Patient Registry. The associations were analysed using conditional Cox and logistic regression.

RESULTS

We did not identify an increased risk of cataract following electrical injury compared to matched controls.

CONCLUSION

A review of the literature clearly substantiates the occurrence of electric cataract as a consequence of electric current coming in contact with a point on the skull or near the eye. However, our results indicate that electric cataract is not a delayed-onset effect of electrical injury, in general, and do not suggest a need for cataract screening in all cases of electrical injury.

Ocular Disease Therapeutics: Design and Delivery of Drugs for Diseases of the Eye

The ocular drug discovery field has evidenced significant advancement in the past decade. The FDA approvals of Rhopressa, Vyzulta, and Roclatan for glaucoma, Brolucizumab for wet age-related macular degeneration (wet AMD), Luxturna for retinitis pigmentosa, Dextenza (0.4 mg dexamethasone intracanalicular insert) for ocular inflammation, ReSure sealant to seal corneal incisions, and Lifitegrast for dry eye represent some of the major developments in the field of ocular therapeutics. A literature survey also indicates that gene therapy, stem cell therapy, and target discovery through genomic research represent significant promise as potential strategies to achieve tissue repair or regeneration and to attain therapeutic benefits in ocular diseases. Overall, the emergence of new technologies coupled with first-in-class entries in ophthalmology are highly anticipated to restructure and boost the future trends in the field of ophthalmic drug discovery. This perspective focuses on various aspects of ocular drug discovery and the recent advances therein. Recent medicinal chemistry campaigns along with a brief overview of the structure-activity relationships of the diverse chemical classes and developments in ocular drug delivery (ODD) are presented.

Presumptive electric cataracts in a Great Horned owl (Bubo virginianus)

This case report describes suspected electrocution in a juvenile female Great Horned owl (Bubo virginianus) with subsequent bilateral cataract formation. The bird flew into a high-voltage power line and was immediately rescued. Burn wounds of the head and ataxia with apparent blindness were noted. Initial ophthalmic examination 5 days after the incident revealed bilaterally symmetrical anterior subcapsular vacuolar cataracts with absence of intraocular inflammation and a predominantly clear view to the normal appearing fundus. The bird appeared to be nonvisual. No ophthalmic medications were prescribed at initial examination. Subsequent recheck examination at 8 weeks revealed moderate resolution of the cataracts and improved vision. To the authors' knowledge, this is the first published report of suspected electric cataracts in an avian species.

Causes of eye burns in children

OBJECTIVE

Eye burns can cause significant ocular morbidity and miss early detection if unsuspected. The objective was to ascertain the reported causes of burns to the eyes in children.

METHODS

Published literature on eye burns in children was searched from 1950 to July 2008 in MEDLINE and from 1982 to July 2008 in CINAHL (Cumulative Index to Nursing and Allied Health Literature) to identify all reported cases.

RESULTS

Forty-two articles from MEDLINE, 5 from CINAHL database, and 6 from the reference lists were included in the analysis. Eye burns in children were caused by thermal, electrical, microwaved food and drinks, and solar hazards. Chemical agents included household cleaning agents, industrial chemicals, certain medications, agricultural chemicals, and some miscellaneous agents. Biological agents reported were millipedes, snake venom, vesicatory insects, and Manchineel tree sap.

CONCLUSIONS

This article shows that children experience eye burns due to many preventable causes. Public education strategies should be implemented to prevent eye burns in children.

The diagnosis and management of electrical injuries

Electrical injuries to the extremity can result in significant local tissue damage and systemic problems. An understanding of the pathophysiology of electrical injuries is critical to the medical and surgical management of patients who sustain these injuries.

Bilateral electric cataracts: clinicopathologic report

We report a case with bilateral intumescent electric cataracts, outcomes of cataract surgery with a new technique, and a histopathologic study of the anterior capsule followed by a review of the literature on electric cataracts. The patient had bilateral cataract extraction and posterior chamber intraocular lens implantation, achieving a visual acuity of 20/20. Hematoxylin and eosin staining of the anterior capsule revealed significant scar tissue formation consisting of fibroblast proliferation and hyaloid production over the basement membrane of the anterior capsule. Electric injuries can cause bilateral intumescent cataracts; the outcomes after cataract surgery are excellent provided the fundus and optic nerve examinations are normal. Scar formation over the anterior capsule may disturb lens nutrition, leading to cataract formation.

Unilateral electric cataract: Scheimpflug imaging and review of the literature

A 22-year-old man presented with diminution of vision in the left eye 1 month after sustaining an injury from a high-voltage electric current to the left side of his head. Slitlamp examination and Scheimpflug imaging confirmed the typical anterior subcapsular lenticular opacities in the left eye and also documented early anterior subcapsular vacuoles in the right eye. Based on history, the electric shock wound, and the typical appearance of the opacities, an electric cataract was diagnosed. The difference in lens density between the 2 eyes was also documented. The best corrected visual acuity (BCVA) was 20/20 in the right eye and counting fingers at 1 foot in the left eye. Phacoaspiration and posterior chamber intraocular lens implantation were performed in the left eye. Postoperatively, the BCVA improved to 20/20. The developmental mechanisms of these opacities after exposure to an electric current and the role of Scheimpflug imaging in assessing the earliest subclinical manifestations of electric cataract injuries are discussed.

Cataract formation after a major burn due to explosion: a case report

Cataract is a very rare complication of burn injuries in which the eye is not directly marked. A unilateral cataract presented some 85 days after a burn injury to a 21-year-old soldier. The cataract was treated surgically with excellent return of vision.