落雷による過剰電流の眼内組織に及ぼす影響

Effect of electric current by lightning on ocular tissues

　48歳男性の落雷による電撃傷の1例について報告した。全身的には，小腸穿孔，体表面積約30％の1〜2度の電撃熱傷，右鼓膜穿孔，下肢の知覚異常と反射の低下及び消失がみられた。受傷直後より，右眼の耳側上方視野のかすみを自覚し当科を受診した。初診時，視力右1.0（n．c．）左1.5（n．c．）と良好であったが右眼水晶体前嚢下に微細な混濁の散在があり，受傷後約2か月半後では，鮮明な花冠状の混濁を呈し，更に受傷約6か月後には花冠状の形態は不鮮明となり前嚢下の混濁は増強し右視力は0.1（n．c．）と低下した。また初診時網膜電位図検査にて，右眼op波の消失と両側b波の減弱，a波の頂点潜時の遅延があったが，経過中いずれも改善傾向を示した。経過中，進行性の網脈絡膜萎縮が認められた。

A patient with ocular symptoms due to electric lightning shock was reported. Electric burn of 1 st or 2 nd degree over 30% of body surface ruptured tympanic membrane, numbness of lower extrimities and absect tendon reflex in the lower extrimities were also existed. His ophthalmological chief complaint at his first visit to our clinic 30 days after injury was upper temporal visual field defect in the right eye. Visual acuity was 20/20 (n. c.) OD and 20/15 (n. c.) OS. One month later, fine subcap-sular cataract was found in the anterior lens epith-elium which was developed to crown-shaped opac-ity within the following one month. Six months after the injury, anteriorsubcapsular opacity was exacerbated and visual acuity decreased to 20/200 (n. c.). ERG examination revealed extinct oscil-latory potentials in the right eye, diminution of b-wave and delayed peak latencies of a-wave in both eyes. These changes were improved in the follow-up studies. Progressive chorioretinal atro-phic spots were developed around just temporal mid-periphery in the right eye and just nasal midperiphery in the left eye. These atrophic lesions could not find at the initial examination.