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 Table of Contents  
Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 44

Barbless fish hook injury to the cornea

1 Cornea and Anterior Segment Services, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
2 Department of Comprehensive Ophthalmology, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
3 Cornea and Anterior Segment Services, KVC Campus, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
4 Cornea and Anterior Segment Services, KAR Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India

Date of Submission30-May-2020
Date of Acceptance08-Aug-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Sushank A Bhalerao
The Cornea Institute, L V Prasad Eye Institute, KVC Campus, Vijayawada - 521 134, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1733_20

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Keywords: Back-out technique, barbless fish hook, fishing, personal eye protection

How to cite this article:
Prasanna L, Vuyyuru S, Kate A, Bhalerao SA, Gogri PY. Barbless fish hook injury to the cornea. Indian J Ophthalmol Case Rep 2021;1:44

How to cite this URL:
Prasanna L, Vuyyuru S, Kate A, Bhalerao SA, Gogri PY. Barbless fish hook injury to the cornea. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Feb 25];1:44. Available from: https://www.ijoreports.in/text.asp?2021/1/1/44/305502

An 11-year-old boy was struck in his left eye by a fishhook while fishing. His father cut the fishing line and tried to remove the hook but failed to dislodge it. The child was brought to our eye hospital 4 h later for necessary intervention to save his eye and vision. On examination, the best-corrected visual acuity (BCVA) was 20/30 in his left eye. The fish hook had penetrated the cornea obliquely, 1 mm from the limbus at 7 O'clock [Figure 1]a. The slit lamp biomicroscopic examination revealed a full thickness 2 mm × 1 mm corneal tear with the fish hook continuing to be lodged at 7 O'clock, a deep anterior chamber, and normal pupillary reaction [Figure 1]b. The fundus examination was normal. The B-scan showed the attached retina and there was no evidence of an intraocular foreign body. The right eye was normal.
Figure 1: (a) The fish hook penetrated the cornea obliquely, 1 mm from limbus at 7 O'clock. (b) Slit-lamp image showing full-thickness corneal tear 2 mm × 1 mm with the presence of the fish hook at 7 O'clock, and a deep anterior chamber. (c) The barbless fish hook. (d) Slit-lamp image on the first post-operative day showing intact corneal suture and deep anterior chamber

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The patient was given 0.5 cc tetanus toxoid injection intramuscularly along with oral antibiotics and immediately shifted to the operation theatre. The patient was operated under general anesthesia. The fish hook was carefully grasped by a pair of forceps and removed from the cornea through the same entry wound using back-out technique. It was clearly identified and categorized as a barbless fish hook [Figure 1]c. The wound was sutured with an interrupted10-0 nylon suture.

On the first post-operative day, the BCVA was 20/20 in the left eye. The corneal suture was intact and the anterior chamber was deep and well formed [Figure 1]d. Topical antibiotics, topical antifungals, and cycloplegics were given.

  Discussion Top

Ocular fishing injuries may cause potentially devastating ocular trauma.[1] When examining the hook, it is important to note whether the fish hook is single, multiple, or treble, if the hook is barbed, the number and location of the barbs as these details help the surgeon decide the best technique of retrieval.[2] The back-out or retrograde method is the simplest technique in which the fish hook is grasped by forceps and simply backed out of the entry wound. Remember, this can be done only for a barbless fish hook or a similar smooth-surfaced object. A barbed fish hook would cause further tissue injury if extracted by using the back-out technique.[3]

Although the back-out method is described in the past, we are presenting the first case of injury to the cornea by a barbless fish hook. This case highlights the importance of understanding the structure of the fish hook and employing an appropriate method of extrication. Finally, as prevention is key to good health, habitual anglers, trainees, hobbyists, and professionals involved in fishing activities must wear adequate personal eye protection as a first step in preventing accidental eye injury.[4] A public service advertising campaign in multiple regional languages could help sensitize the public on care of the eyes during fishing and related activities.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Srinivasan S, Macleod S. Fish hook injury to the eyelid. Indian J Ophthalmol 2001;49:115.  Back to cited text no. 1
[PUBMED]  [Full text]  
Gammons M, Jackson E. Fishhook removal. Am Fam Physician 2001;63:2231-6.  Back to cited text no. 2
Mishra S, Rout JP, Sharma PK, Govindaraj B, Mahapatra B. Fish hook injury of eyelid: An unusual case. Nigerian J Ophthalmol 2016;24:7.  Back to cited text no. 3
Purtskhvanidze K, Saeger M, Treumer F, Nölle B, Roider J. Open globe and penetrating eyelid injuries from fish hooks. BMC ophthalmol 2019;19:1-5.  Back to cited text no. 4


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