Delayed‐Onset Electric Cataract Following High‐Voltage Electrical Injury

ABSTRACT

This study described a rare case of a 46‐year‐old man presented with a 27‐year history of visual reduction in his right eye. He reported a 27‐year history of an electric shock that led to immediate unconsciousness. On admission, his best‐corrected visual acuity was hand motion in the right eye and 20/20 in the left eye. Examination revealed anterior subcapsular patchy opacities with a central calcification‐like appearance in the right lens and patchy opacities in the left lens. Several irregular skin scars were visible on his head and left lower extremity. He was diagnosed with electric cataract and injury. He underwent cataract phacoemulsification with intraocular lens implantation in the right eye. Complete resolution of symptoms was achieved at a 1 week follow‐up.

Summary.

• High‐voltage electrical injury is a life‐threatening condition with a high mortality rate.

• It usually presents with compound injury and requires specialist care from a multidisciplinary team.

• Electric cataract is considered to be a rare form of electrical injury, resulting in sudden and severe vision loss.

1. Case Presentation

A 46‐year‐old man presented with a 27‐year history of visual impairment following an electrical injury sustained at age 19. He reported a history of an electric shock that led to immediate unconsciousness at the workplace 27 years ago. A direct current of 30,000 V passed through his head and exited from the lower extremity. On physical examination, his best‐corrected visual acuity was hand motion in the right eye and 20/20 in the left eye. Slit‐lamp examination revealed anterior subcapsular patchy opacities with central calcification‐like opacities (Figure 1A, red arrows) in the right lens and patchy calcification‐like opacities (Figure 1B, red arrows) in the left lens. The cornea, pupil, and fundus were normal in each eye. Several irregular skin scars were visible on his head (Figure 2A, red arrows) and left lower extremity (Figure 2B,C, red arrows). A diagnosis of electric cataract and injury was made. He underwent cataract phacoemulsification with intraocular lens implantation in the right eye. During the operation, the calcified plaques were removed using phacoemulsification. The posterior capsule was clear and well‐preserved. No intraoperative complications were found. At a 1 week follow‐up, complete resolution of symptoms was achieved; a clear intraocular lens was visible (Figure 3). His best‐corrected visual acuity improved to 20/20 in the right eye. During a further 6 month follow‐up period, his visual acuity remained stable. Fundus examination results were within normal limits, and no recurrence was observed.

FIGURE 1.

Clinical photographs in a 46‐year‐old man with a high‐voltage electrical injury. On admission, slit‐lamp examination revealed anterior subcapsular patchy opacities with central calcification‐like opacities (A, red arrows) in the right lens and patchy calcification‐like opacities (B, red arrows) in the left lens.

FIGURE 2.

Several irregular skin scars were visible on his head (A, red arrows) and left lower extremity (B and C, red arrows).

FIGURE 3.

At a 1 week follow‐up, complete resolution of symptoms was achieved; a clear intraocular lens was visible.

2. Discussion

High‐voltage electric injury is a rare but life‐threatening condition with a high mortality rate [1]. It usually presents with compound injury (e.g., skin burn, cardiac damage, and cataract). Specialist care from a multidisciplinary team (e.g., ophthalmology, dermatology, neurosurgery, and internal medicine) is required to rule out systemic complications from the high‐voltage electrical injury [1, 2].

Eye (cornea, macula, and lens) involvement associated with high‐voltage electric injury was uncommon. Macular injury after electric shock was related to irreversible visual reduction [1]. Electric cataract is considered to be an acute form of electrical damage, resulting in severe progressive or sudden visual reduction [1]. However, compared with existing literature, the present case was a delayed‐onset electric cataract, highlighting pathological differences and time‐course variations. The underlying mechanisms of cataract formation following electrical injury include direct damage to lens epithelial cells, oxidative stress, protein denaturation/necrosis, disruption of lens microcirculation, or ionic balance [1]. Without treatment, patients may result in serious complications and poor prognosis. Surgical removal for cataract along with intraocular lens implantation is proven effective for improving visual outcomes [3].

Author Contributions

Gang Huang: writing – original draft. Bei Wang: writing – review and editing. Xiaogui Zhao: software. Bangtao Yao: writing – review and editing.

Ethics Statement

The study was approved by the Institutional Review Board of Nanjing Lishui People's Hospital.

Consent

Written informed consent was obtained from patient to publish this report in accordance with the journal's patient consent policy.

Conflicts of Interest

The authors declare no conflicts of interest.

Huang G., Wang B., Zhao X., and Yao B., “Delayed‐Onset Electric Cataract Following High‐Voltage Electrical Injury,” Clinical Case Reports 13, no. 10 (2025): e71134, 10.1002/ccr3.71134.

Data Availability Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.