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Bilateral macular hole secondary to remote lightning strike.

Rao KA, Rao LG, Kamath AN, Jain V - Indian J Ophthalmol (2009 Nov-Dec)

Bottom Line: Examination revealed relative afferent pupillary defect in the RE.Posterior subcapsular cataract was noted in both eyes.This is the first case report of such nature in India to the best of our knowledge.

View Article: PubMed Central - PubMed

Affiliation: Department Of Ophthalmology, Kasturba Medical College, Manipal, India.

ABSTRACT
We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE) immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE) stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.

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Left eye posterior subcapsular cataract
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Figure 0002: Left eye posterior subcapsular cataract

Mentions: A 16-year-old girl presented to us with sudden painless diminution of vision in the right eye (RE) following a lightning strike while sleeping in the house on the ground at night two months ago (April 2008). Her brother-in-law, who was sleeping approximately six feet away died immediately but this girl survived and experienced immediate decreased vision in the RE and loss of hearing in the right ear. However, she reported for ophthalmic evaluation two months later in June 2008. On examination, her best-corrected visual acuity was 20/80, N18 in RE and 20/30, N10 in left eye (LE). Intraocular pressure was 12 and 10 mm Hg respectively. Anterior segment examination revealed RE relative afferent pupillary defect (RAPD). Posterior subcapsular cataract was noted in both eyes [Figs. 1 and 2]. Her fundus examination revealed bilateral macular holes [Figs. 3 and 4] and multiple areas of retinal pigment epithelium (RPE) hyperpigmentation in the periphery in both eyes [Fig. 5]. Posterior vitreous detachment or operculum was not found. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and RPE stippling in the periphery in both eyes [Figs. 6–8]. General physical examination showed stable pulse, blood pressure and renal function. Our patient did not sustain any skin or eyelid burns. On her last visit in July 2008, she was found to have RE anterior uveitis and has been treated with topical steroids and cycloplegics.


Bilateral macular hole secondary to remote lightning strike.

Rao KA, Rao LG, Kamath AN, Jain V - Indian J Ophthalmol (2009 Nov-Dec)

Left eye posterior subcapsular cataract
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2812771&req=5

Figure 0002: Left eye posterior subcapsular cataract
Mentions: A 16-year-old girl presented to us with sudden painless diminution of vision in the right eye (RE) following a lightning strike while sleeping in the house on the ground at night two months ago (April 2008). Her brother-in-law, who was sleeping approximately six feet away died immediately but this girl survived and experienced immediate decreased vision in the RE and loss of hearing in the right ear. However, she reported for ophthalmic evaluation two months later in June 2008. On examination, her best-corrected visual acuity was 20/80, N18 in RE and 20/30, N10 in left eye (LE). Intraocular pressure was 12 and 10 mm Hg respectively. Anterior segment examination revealed RE relative afferent pupillary defect (RAPD). Posterior subcapsular cataract was noted in both eyes [Figs. 1 and 2]. Her fundus examination revealed bilateral macular holes [Figs. 3 and 4] and multiple areas of retinal pigment epithelium (RPE) hyperpigmentation in the periphery in both eyes [Fig. 5]. Posterior vitreous detachment or operculum was not found. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and RPE stippling in the periphery in both eyes [Figs. 6–8]. General physical examination showed stable pulse, blood pressure and renal function. Our patient did not sustain any skin or eyelid burns. On her last visit in July 2008, she was found to have RE anterior uveitis and has been treated with topical steroids and cycloplegics.

Bottom Line: Examination revealed relative afferent pupillary defect in the RE.Posterior subcapsular cataract was noted in both eyes.This is the first case report of such nature in India to the best of our knowledge.

View Article: PubMed Central - PubMed

Affiliation: Department Of Ophthalmology, Kasturba Medical College, Manipal, India.

ABSTRACT
We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE) immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE) stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.

Show MeSH
Related in: MedlinePlus