LAUSR

Electrical injury is not uncommon as many people come into contact with electricity on daily basis. However only few cases of electrical cataract have been reported because very few patients survive after a high electric voltage, that is needed to induce cataract [1–3]. Most of the cases of electrical injury have no visual complaints in the early period but their visual acuity decreases after a few months of injury with the development of cataract [2, 4]. We saw six young patients in Kashmir valley in India over 2013–2017 developing bilateral electrical cataracts at our tertiary care centre. Three patients (labourers) had electrical injury while at work, whereas the other three had high voltage wires falling on them while walking on the street. In this part of the world, electricity runs via overhead wires that are uninsulated, increasing the chances of such electrical injury. All these patients were under 40 years of age. The cataracts formed were soft but total cataracts that could be easily aspirated providing good visual gain. All the patients had an entry and exit wound. One of the patients required an amputation of his hand while another had total loss of his ear lobe at the exit wound. Electrical cataracts causing bilateral blindness at a young age is of great concern, as what we may be seeing is only part of a much bigger problem that needs to be tackled at its roots. Our apprehension lies in that such injuries are totally avoidable if an extra amount of care is taken while working at such high voltage currents and if overhead wires are properly insulated. Electrical insults to the human body can result in a wide range of ocular injuries with resultant ocular complications An incidence of 6.2% of cataracts is reported following electric injury [4]. Korn and Kikkawa [5] describe a patient post electrical injury with bilateral cataracts and optic atrophy with widespread macular pigment disruption who later developed retinal detachment causing permanent visual impairment. While none of our patients had retinal complications, one needs to follow up these cases over long term due to the potential of retinal detachments later on. For the state of Kashmir which harbours one of the highest rates of blindness in India and is riddled with social conflict, government efforts need to be harnessed to prevent this public health issue. What we observed at our apex eye care centre could just be the tip of the iceberg.