Unusual ophthalmic presentation of electrical injury

Abstract

Electric injuries to the eye are rare and have  varied sequalae. We describe a case that presented to us with neurotropic keratitis and cataract. A 57 year old   gentleman presented to us with a history of electric shock and complaints of decreased vision and pain in the left eye since the episode. He was treated elsewhere for bilateral epithelial defects and was symptom free in the right eye. On  examination, he was found to have a corneal scar in the right eye and a neurotropic corneal ulcer with conjunctivalisation in the left eye. He was also noted to have bilateral cataracts. He was managed conservatively with patching and lubricants and the epithelial defect closed. We postulate that the corneal nerves could have been directly affected due to the electricity flow, or due to thermal damage as a result of flow through the nerves. The cornea may also have suffered additional thermal damage, leading to abnormal epithelisation. This may have been compounded by tear film abnormalities.