Evolution of Lightning Maculopathy: Presentation of Two Clinical Cases and Brief Review of the Literature

Lightning is a naturally occurring atmospheric phenomenon. Though uncommon, it is a potentially devastating and underreported natural calamity. Lightning accounts for the second leading cause of weather-related death in most parts of the world. Among the survivors of lightning injury, more than half of the victims may suffer from some form of ophthalmic injury. The lightning-associated ocular injury varies from a range of anterior segment to posterior segment pathologies. We report on two clinical cases of ocular injuries among the survivors of lightning injury. Anatomical involvement is seen at different levels with presentation as uveitis, pupillary abnormality, maculopathy, and later development of lenticular opacification. Optical coherence tomography (OCT), a noninvasive diagnostic tool, is particularly useful in the evaluation of lighting maculopathy as well as to monitor its progression through the course of time. Visual prognosis depends upon the structures of the eyes affected in the injury. The presence of irreversible retinal damage as well as optic nerve damage often result in poor visual outcome in the absence of significant anterior segment pathology. This report highlights the evolution of maculopathy through the course of time and signifies the importance of long-term follow-up postlightning injury.

Lightning Injury with Multi-System Involvement

Lightning leads to trauma and disability such as burns, hearing loss, blindness, cardiac arrhythmia, cardiac arrest, stroke, kidney injury, and can also lead to death. Such cases are seldom reported, and hence their database is scanty. We present a case of a 40-year-old female with lightning injury with four such manifestations, which is not commonly encountered. We have elaborated on these complications of lightning injury and their timely management, which has led us to good patient outcome.

Lightning Maculopathy: A Case Report

Lightning induced maculopathy is a very rare condition and there are barely any published reports on lightning induced maculopathy in our country. Here we present a case of twenty three years female who presented with lightning induced burns on the neck, chest and abdomen. She had unconsciousness for 3 days after lightening injury for which she was treated in intensive care unit. She presented with complain of diminution of vision in both eyes after 2 weeks. Optical Coherence tomography revealed cystic changes in fovea in right eye and a macular hole in left eye. Lightning injury is a life threatening condition. Lightning maculopathy should always be ruled out which can be best detected on optical coherence tomography. Keywords: foveal cyst; lightning injury; maculopathy; optical coherence tomography.