Electrical current is characterized by the movement of the electrons between two points that

exhibit a potential gradient through a conductor. This current is measured by the Ampire (I).
Electrical injuries are a common form of mechanical trauma. Although these injuries are usually
preventable, they are often associated with high morbidity and mortality. In the United States,
approximately 1000 deaths occur annually as a result of electrical injuries. Zemaitis MR, Foris
LA, Lopez RA, Huecker MR. Electrical Injuries. In: StatPearls. StatPearls Publishing, Treasure
Island (FL); 2022. PMID: 28846317 A specific subtype of electrical injury is lightning strikes,
which is responsible for the death of about 25-50 people each year.   Gentges, J., & Schieche,
C. (2018). Electrical injuries in the emergency department: an evidence-based review.
Emergency medicine practice, 20(11), 1–20.

Electrical injuries commonly occur from household and occupational exposures. Three main
groups of people are at a higher susceptibility for such injuries. These include young children,
who are most frequently injured from the household current, adolescent males due to their
engagement in high risk behaviors, and lastly, adult males, particularly construction workers and
electricians, who face higher risks of electric injury from occupational exposure. (9) Gentges, J.,
& Schieche, C. (2018). Electrical injuries in the emergency department: an evidence-based
review. Emergency medicine practice, 20(11), 1–20.

Electrical injuries have a widespread impact on almost all of the organs in the body, including
the central nervous system (CNS) and the eyes. The outcomes of these injuries vary
significantly, ranging from superficial burns to electrocution, which refers to death from electrical
injuries. There are several factors that determine the severity of the electric injury, such as the
voltage, type (direct or alternating), and strength of the current, the duration of exposure,
resistance to the current flow, and the path of the current while passing through the body.
Waldmann, V., Narayanan, K., Combes, N., Jost, D., Jouven, X., & Marijon, E. (2018). Electrical
cardiac injuries: current concepts and management. European heart journal, 39(16), 1459–
1465. https://doi.org/10.1093/eurheartj/ehx142

Despite being uncommon, ocular injury from electric shock is a serious condition that has been
reported in numerous case reports and other studies. The first documented case of electric eye
injuries was reported in 1722 by St Yves when a field worker developed lenticular opacities
(cataract) after being struck by lightning.

The consequences of ocular electrical injury can affect almost any part of the eye, including the
eyelids, conjunctiva, extraocular muscles, cornea, iris and pupil, lens, retina, choroid, and optic
nerve. (6)  Bae EJ, Hong IH, Park SP, Kim HK, Lee KW, Han JR. Overview of ocular
complications in patients with electrical burns: an analysis of 102 cases across a 7-year
period. Burns. 2013;39(7):1380-1385. doi:10.1016/j.burns.2013.03.023

Cataract, which is the commonest ocular manifestation reported to occur after electric injury
(Sharma A), was documented in approximately 5% to 20% of the patients who suffered from
electric shock. It was also reported that cataract takes some time to develop, and may not
necessarily be present at the time of injury, therefore, early ophthalmologic consultation along
with close follow up, is crucial for these patients. Friedstat J, Brown DA, Levi B. Chemical,
Electrical, and Radiation Injuries. Clin Plast Surg. 2017;44(3):657-669.
doi:10.1016/j.cps.2017.02.021

Retinal manifestations were also commonly reported, with a wide spectrum of injuries varying
from development of macular holes up to retinal detachments. Sharma A, Reddy YCVG, Shetty
AP, Kader SMA. Electric shock induced Purtscher-like retinopathy. Indian J Ophthalmol.
2019;67(9):1497-1500. doi:10.4103/ijo.IJO_1737_18

Tissue damage from electrical injuries is explained by several mechanisms, including the effect
of the current on the cell membrane, the conversion of the electrical injury to heat in the tissues,
and the resultant tissue ischemia that is attributed to vasoconstriction or cardiac insufficiency.
Grover S, Goodwin J. Lightning and electrical injuries: neuro-ophthalmologic aspects. Semin
Neurol. 1995;15(4):335-341. doi:10.1055/s-2008-1041041 Furthermore, the effect of electrical
injury on different body tissues differs according to the tissue’s resistance. Generally, bone has
the highest resistance against electric injury while the nerves have the least resistance.
Fontanarosa PB. Electrical shock and lightning strike. Ann Emerg Med. 1993;22(2 Pt 2):378-
387. doi:10.1016/s0196-0644(05)80468-8  

 Since most of the electrical injuries are largely avoidable, the best management of these
injuries is prevention. Health education of workers at high risk of exposure to comply with
protective measures such as wearing rubber insulating gloves and shoes and industrial
protective hamlets are crucial to avoid these injuries, in addition to providing a safe work
environment by regular checking of electrical installations, and implementing safety instructions.
For domestic hazards, public education regarding proper supervision of kids, removal of bare
wires and avoidance of using electricity with wet hands are the main ways to decrease these
accidents. Chaudhry, T. A., Shaikh, F., & Ahmad, K. (2012). Healing of cornea following an
electric burn. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 22(8),
533–535.

In this systematic review, we documented the available case reports and the resulting ocular
manifestations from electric injuries. We aim to identify the spectrum of ocular injuries, explore
the associated risk factors for such cases. We also aim to provide health care professionals and
ophthalmologists with a comprehensive review of the ocular manifestations of electric injuries,
and the importance of early detection and management.