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| PHOTO ESSAY |
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| Year : 2021 | Volume
: 1
| Issue : 1 | Page : 44 |
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Barbless fish hook injury to the cornea
Lakshmi Prasanna1, Sowjanya Vuyyuru2, Anahita Kate3, Sushank A Bhalerao3, Pratik Y Gogri4
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 Submission | 30-May-2020 |
| Date of Acceptance | 08-Aug-2020 |
| Date of Web Publication | 31-Dec-2020 |
Correspondence Address:
Dr. Sushank A Bhalerao
The Cornea Institute, L V Prasad Eye Institute, KVC Campus, Vijayawada - 521 134, Andhra Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijo.IJO_1733_20
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 |
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 | |  |
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.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Srinivasan S, Macleod S. Fish hook injury to the eyelid. Indian J Ophthalmol 2001;49:115.  [ PUBMED] [Full text] |
| 2. | Gammons M, Jackson E. Fishhook removal. Am Fam Physician 2001;63:2231-6. |
| 3. | Mishra S, Rout JP, Sharma PK, Govindaraj B, Mahapatra B. Fish hook injury of eyelid: An unusual case. Nigerian J Ophthalmol 2016;24:7. |
| 4. | 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. |
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