LONG-TERM OPHTHALMOLOGICAL CONSEQUENCES OF ELECTRIC TRAUMA. CLINICAL CASE.

describe the clinical case of a patient with electrotrauma.

Today in Ukraine, in wartime, the issue of electrocution is quite relevant. This is connected with the unstable situation in the electrical system of Ukraine, which is quite dangerous and endangers the health and lives of citizens.

a patient born in 2003, with remote consequences of electrotrauma while at the railway station. Diagnosis (March 2022): state after electrotrauma. 2nd-3rd degree electric arc flame burn, polytrauma. total electric injury (27,000). 2nd or 3rd degree electric arc flame burn, area 70% of the head, torso, both upper and left lower limbs . Post-traumatic amputation of 2-4 fingers of the right hand. Partial atrophy of the right optic nerve, neuroopticopathy of the left optic nerve of central origin.
 Today's diagnosis: Partial atrophy of the optic nerves of both eyes. Complicated posterior capsular cataract of the right eye. Dry eye disease of both eyes.
The patient underwent general clinical and ophthalmological examination methods (visometry, tonometry, perimetry, biomicroscopy, ophthalmoscopy, optical coherence tomography).

OD eyelids are unchanged, the conjunctiva is pale pink, smooth. The cornea is transparent, the cornea is of medium depth, the iris is unchanged, the pupil is round, it reacts sluggishly to light and to mydriatics. Lens - turbidity is localized on the posterior capsule. The vitreous body is unchanged. Details of the fundus are not ophthalmoscoped.
The eyelids are unchanged, the conjunctiva is pale pink, smooth. The cornea is transparent, the cornea is of medium depth, the iris is unchanged, the pupil is round, it actively reacts to light. The lens is unchanged. The vitreous body is unchanged. The fundus of the DZN is pale, the boundaries are clear, the arteries are narrowed, the veins are of normal caliber, the macular area is without visible pathology
Field of vision: OD - concentric narrowing, absolute central scotoma. OS – concentric narrowing.
OCT: OD – thinning of the peripapillary layer of nerve fibers and ganglion cells of the retina.
In October 2022, the patient underwent surgical intervention - m/x phacoemulsification of the cataract on the right.
After the operation, the visual acuity of the right eye is 0.5, objectively: the eyelids are unchanged, the conjunctiva is pale pink, smooth. The cornea is transparent, the cornea is of medium depth, the iris is unchanged, the pupil is round. The optical part of the IOL is in the posterior capsule. The vitreous body is unchanged. The fundus of the DZN is pale, the borders are clear, the arteries are narrowed, the veins are of normal caliber, the macular area is without visible pathology.

Thus, the given clinical case - electrotrauma by the flame of a voltaic arc with damage to the head can lead to descending atrophy of the optic nerve and the development of complicated cataracts. While preserving the visual field, cataract removal is reasonable and proven to improve visual acuity.