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Ophthalmic Images
January 11, 2018

Rosette-Shaped Cataract Due to Lightning Injury

Author Affiliations
  • 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida
  • 2Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida
JAMA Ophthalmol. 2018;136(1):e175719. doi:10.1001/jamaophthalmol.2017.5719

A 57-year-old woman presented with photopsias and floaters in her right eye. A rosette-shaped cataract was seen in her right eye (Figure), and her left eye showed a clear lens. A posterior vitreous detachment was noted in the right eye, but there were no retinal tears or detachments. There were no signs of prior ocular trauma.

The patient had been struck by lightning as a child. Lightning injuries are rare; however, they can have ocular sequelae, most frequently cataract formation. Cataracts can occur from mechanical damage, decreased permeability of the lens capsule, protein coagulation, or nutritional alterations of the lens. Opacification of the lens cortex or capsule can result in stellate-shaped or rosette-shaped cataracts.1 Bilateral cataracts are more common; however, unilateral cases have been reported1 and are typically observed on the side of the body hit by the lightning currents.

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