Multimodal imaging of ocular electric injury: Case report and review of literature

We report a rare case and review the literature of bilateral anterior subcapsular cataract with asymmetric impending macular holes (IMHs) following high-voltage electrical injury. A 35-year-old male presented with painless, progressive blurring of vision in both eyes (right worse than left) over 2 months. He had a history of electrocution 3 months prior. There was no other significant medical history. Multimodal imaging revealed bilateral cataract, an IMH, with greater severity in the eye contralateral to the contact site. The right eye underwent phacoemulsification, and the anterior capsule tissue was analyzed using transmission electron microscopy (TEM). TEM showed mitochondrial edema, nuclear enlargement, and increased fibrosis compared to the normal crystalline lens. This case emphasizes the diverse ocular manifestations of electrical trauma and the importance of multimodal imaging and electron microscopy in understanding electric cataract pathogenesis.