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CASE REPORT
Year : 2018  |  Volume : 11  |  Issue : 2  |  Page : 178-179  

Electrical injury of irides


Department of Ophthalmology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia

Date of Web Publication18-May-2018

Correspondence Address:
Syed S Ahmad
Department of Ophthalmology, Queen Elizabeth Hospital, 88586 Kota Kinabalu, Sabah
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MJDRDYPU.MJDRDYPU_272_16

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  Abstract 


Electrical injuries to the eye can have diverse manifestations. However, uveal tract injuries following exposure to electric current are infrequently reported. The present case report describes pigmentary changes in both irides in a 22 year old man following electrical injury. The changes persisted during the period of follow up for six months. Vision was not affected. This case report highlights a rarely reported feature of ocular electrical injury.

Keywords: Electrical injury, iris, pigmentary changes


How to cite this article:
Ahmad SS. Electrical injury of irides. Med J DY Patil Vidyapeeth 2018;11:178-9

How to cite this URL:
Ahmad SS. Electrical injury of irides. Med J DY Patil Vidyapeeth [serial online] 2018 [cited 2022 Jun 25];11:178-9. Available from: https://www.mjdrdypv.org/text.asp?2018/11/2/178/232646




  Introduction Top


Electrical injuries to the body can be associated with varying degrees of morbidity and occasionally even fatality. Ocular manifestations following electrocution include early changes such as: corneal opacities, intraocular hemorrhage, retinal edema, spasm of retinal vessels and central retinal vein thrombosis. While late changes reported are: iridocyclitis, lens opacities, pupillary dysfunction, accommodation paralysis, extra-ocular muscle weakness, chorio-retinitis, retinal degeneration, optic disc edema, optic nerve atrophy and “electrical cataracts”.[1] Uveal tissue changes following electrical injury are only rarely reported. Herein, we present a case report of a 22-year old male who developed extensive pigmentary changes of the irides following exposure to electrical current. These changes are rarely, if ever, reported and are being presented for the rarity of the condition.


  Case Report Top


A 22-year-old man was referred to our clinic for assessment, following exposure to electric current a week previously. The patient accidentally touched a live wire when he was repairing an electric circuit in his factory. He fell down following immediate loss of consciousness. The patient was stabilized in the emergency department and kept in the Intensive Care Unit (ICU) where he regained consciousness in a few hours. No neurological deficits were observed during his uneventful progress there. At the time of discharge from the ICU, he was noticed to have some difference in the color of his both irides and was referred to us.

On examination, his unaided vision was 6/6 in both eyes. The intraocular pressures in both eyes were 14 mmHg. The anterior and posterior segment abnormalities were limited to sectoral pigmentary changes on the irides. The changes were more extensive in the right eye compared to the left eye, where the changes were limited to the inferior half [Figure 1], [Figure 2], [Figure 3], [Figure 4]. No retroillumination defects were observed in either eye. Pupillary reactions and extraocular movements in both eyes were normal as well.
Figure 1: Slit lamp image of the right eye

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Figure 2: Anterior segment photograph of the right eye showing iris burn

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Figure 3: Slit lamp image of the left eye

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Figure 4: Anterior segment photograph of the left eye showing iris burn

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  Discussion Top


There have been a number of case reports which describe the ocular changes seen following electrical injury.[1],[2] Almost every structure or tissue of the eye and the adnexa may bear the insult of electrical injury. Manifestations of electrical injuries to the uveal tract are infrequently reported.[3] In the iris and pupil, features reported include iritis, iris atrophy, pigment dispersion, Horner's syndrome, miosis, and often anisocoria.[4] Most of these conditions are temporary and resolve with time. Our patient showed extensive pigmentary changes on both irides, especially in the region of the collarette. A 6-month follow-up of our patient has not shown any significant change in the pigmentary appearance of the irides.

In general, electrical injuries can be of high- or low-voltage type.[5] The clinical features seen in these cases can be attributed to a direct consequence of the electrical current; conversion of electrical energy into thermal energy;and secondary effects. Cataracts can result from the direct effect of the current on lens proteins or contraction of the ciliary muscles resulting in concussion-type injuries. Changes in capsular permeability or thermal damage may also play a role in cataract formation. In the retina, loss of choroidal and retinal vasculature or electroporation may result in coagulative necrosis.[6] In any type of tissue, the severity of the injury is determined by the voltage, current intensity, type of current, the current pathway, duration of exposure, resistance of the tissues, and the contact surface.

The higher the voltage of the current, resistance of the material through which current is passing and the duration of exposure, the more severe is the injury. Thus, the circumstance in which electrical injury occurs has a profound effect on the extent of injuries seen. In the iris, the conversion of electrical energy into thermal energy could possibly bring about the kind of pigmentary changes seen in this patient.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bienfang DC, Zakov ZN, Albert DM. Severe electrical burn of the eye. Albrecht Von Graefes Arch Klin Exp Ophthalmol 1980;214:147-53.  Back to cited text no. 1
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2.
Salowi MA, Choong YF. Neurotrophic keratitis secondary to electrocution injury. Asian J Ophthalmol 2007;9:39-40.  Back to cited text no. 2
    
3.
Al Rabiah SM, Archer DB, Millar R, Collins AD, Shepherd WF. Electrical injury of the eye. Int Ophthalmol 1987;11:31-40.  Back to cited text no. 3
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4.
Miller BK, Goldstein MH, Monshizadeh R, Tabandeh H, Bhatti MT. Ocular manifestations of electrical injury: A case report and review of the literature. CLAO J 2002;28:224-7.  Back to cited text no. 4
[PUBMED]    
5.
Martinez JA, Nguyen T. Electrical injuries. South Med J 2000;93:1165-8.  Back to cited text no. 5
[PUBMED]    
6.
Zablocki GJ, Hagedorn CL. Chorioretinal atrophy after electrical injury. Digit J Ophthalmol 2011;17:40-2.  Back to cited text no. 6
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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  Introduction
  Case Report
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   References
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