Double whammy – High voltage optic neuropathy and compressive optic neuropathy

Abstract

Electric current flows in the body between two contact points. The degree of damage caused by the current is dependent on voltage intensity, tissue resistance, type of current, duration and area of contact and the route the current traveled within the body. Ophthalmic injuries are common with electrical damage to the body. Blepharospasm, keratopathy, uveitis, corneal opacities, cataracts, vitreous hemorrhage, retinal edema, macular hole and vascular occlusions are the frequently encountered ones. Here in this case, we report a very rare coincidence of optic neuropathy triggered by high voltage electrical injury (electrocution) and an occult pituitary macroadenoma which coexisted in the same individual causing compressive optic neuropathy. The patient was treated initially as optic neuropathy with steroids and later the macroadenoma was excised under neuro-surgical guidance. This case necessitates the importance of investigating temporal pallor in young individuals and arrival at a proper diagnosis which otherwise could be vision as well as life threatening.