A case of electric cataract

Eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation: A systematic review and meta-analysis

OBJECTIVES

To evaluate the risk of developing eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation.

METHODS

Our literature search captured articles published in Embase, Web of Science, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar databases until September 2021. Then, we retrieved articles reporting cataracts and eye lens opacities induced by radiation exposure among healthcare professionals. The outcomes of interest were cataracts, nuclear opacity, cortical opacity, posterior subcapsular opacity, and any lens opacity.

RESULTS

Of the 4123 articles identified, 15 studies met the inclusion criteria. Healthcare workers exposed to radiation had a significantly greater risk of posterior subcapsular cataracts (PSCs), cataracts, and any lens opacities than those of the non-exposed participants (p<0.05). The cortical opacity was not significantly different between the exposed and non-exposed participants (p>0.05). Radiation was not determined to be a risk factor for nuclear opacity as it was significantly greater in the control group than the exposed participants. Subgroup analysis revealed that nurses had the highest risk for PSCs (risk ratio = 4.00), followed by interventional cardiologists (risk ratio = 3.85).

CONCLUSION

The risk of posterior subcapsular opacities and cataracts is significantly higher in healthcare workers with occupational radiation exposure than in non-exposed workers, highlighting the necessity to enhance and promote the wearing of protective measures with high safety levels.

ASIAN ELEPHANT (ELEPHAS MAXIMUS) SUFFERING FROM LIGHTNING STRIKE SUCCESSFULLY TREATED BY INTEGRATIVE VETERINARY MEDICINE

A captive female Asian elephant (Elephas maximus), approximately 30 yr old, was struck by lightning and displayed obtundation, dysphagia, drooling, and muscle weakness. A physical examination, hematologic test, blood gas analysis, and electrocardiogram were performed. Treatments included the administration of mannitol, dexamethasone, antibiotics, analgesics, vitamins, and intravenous fluid. Conventional therapy resulted in improvement but not complete resolution of clinical signs. Therefore, acupuncture was integrated into the treatment protocol. Electroacupuncture and laser acupuncture were administered every other day; aqua acupuncture was administered once a week. No complications were observed during acupuncture treatment. Acupuncture, a form of traditional Chinese veterinary medicine (TCVM), contributed to the resolution of clinical signs in this case and may be an effective adjunctive treatment for other neurologic disorders in elephants.

Simultaneous Cataract, Maculopathy and Optic Atrophy Secondary to High-Voltage Electrical Shock Injury

A 32-year-old man presented to our clinic with complaint of vision loss in both eyes (oculus utro; OU). Past medical history revealed that he had been exposed to high-voltage electrical current that passed through the temporal region of the head 2 months ago. Slit-lamp examination demonstrated cortico-nuclear cataract and mature cataract in his right eye (oculus dexter; OD) and left eye (oculus sinister; OS), respectively. On fundus examination, a macular hole was observed in OD. Optic atrophy and foveal atrophy were observed in the left fundus examination after cataract surgery. Simultaneous cataract, maculopathy and optic atrophy may occur after high-voltage electrical current injury. Therefore, clinicians should perform detailed anterior and posterior segment examinations in such patients.