Acute cataract and optic atrophy after high-voltage
M. Riaz Khan
H.M.A. El Faki
Received: 22 February 2007 / Accepted: 20 November 2007 / Published online: 4 January 2008
Abstract High-voltage electrical injuries may result in
cataract formation. A patient who developed cataract and
optic atrophy of the right eye during the first 2 weeks after
injury is presented. The patient did not develop cataract in
his left eye. High-voltage electrical injuries may result in
cataract formation, and therefore an eye examination should
be performed by an experienced ophthalmologist.
Keywords Acute cataract
High-voltage electrical injury
Electrical injuries are common in our country and approx-
imately 10 cases per year are admitted to our unit. High-
voltage electric currents cause more severe lesions, resulting
in vascular and neurological complications.
Electrical injury can cause coagulation of proteins in the
lens leading to opacity or cataract and loss of vision. It usually
complicates high-voltage electrical injuries involving the head
and neck region. It has been reported that electrical cataracts
may regress, remain stationary, or progress to a complete or
mature cataract over weeks to years.
A 35-year-old man was transferred to our burns unit from a
construction site 90 miles away, 2 h after the accident. He
had been injured while lifting building materials on a high
vehicle and accidentally his head touched a high-voltage
cable of 4,000 V. On admission, he was conscious and
quiet. His general condition was satisfactory.
The injury involved the right parietal scalp with a full
thickness dead white patch of 4×12 cm. The exit site involved
the middle three toes of his left foot (Fig 1). He was treated
with regular eusol and eusol paraffin packs until the dead scab
over the parietal area separated 8 weeks after admission. The
exposed outer table of the parietal scalp was covered with a
right forearm flap that was divided and inset after 3 weeks.
The patient started to complain of blurring of vision in
the right eye 2 weeks after the injury. Three weeks later, the
cataract had progressed and he completely lost vision in the
right eye. Ophthalmologic examination revealed complete
right optic atrophy (Fig 2).
High-voltage electrical injury is a devastating form of trauma,
which frequently results in vascular and neurological compli-
cations. Once the integrity of the skin is destroyed, the
majority of the electric current travels through the least
resistant tissues such as nerves, blood vessels, and muscles.
El Faki reported in 1993  that high-voltage electrical
injury causes blockage and thrombosis of nutrient vessels,
thus resulting in necrosis of tissues. Norman et al. (1975) 
and Ratnayke et al. (1996)  reported cases resulting in
neurological complications. In these publications, the
common neurological sequelae are sensory neuropathy
and motor paralysis. Very few cases of cataract formation
have been reported in the literature, as it is usually a late
complication [2, 4, 6].
Our patient started to develop opacification of the lens of
the right eye on the second week of injury and develop a
Eur J Plast Surg (2008) 31:73–74
M. R. Khan (*)
H. El Faki
Abu Dhabi, United Arab Emirates