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| CASE REPORT |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 304-305 |
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A rare case of corneal perforation with glass perchlet fish
S Parab Shubhescha1, P S Usgaonkar Ugam1, Nachnolkar Ravina2
1 Department of Ophthalmology, Goa Medical College, Bambolim, Goa, India
2 Department of Ophthalmology, Subdistrict Hospital, Ponda, Goa, India
| Date of Submission | 02-Oct-2022 |
| Date of Acceptance | 09-Jan-2023 |
| Date of Web Publication | 28-Apr-2023 |
Correspondence Address:
S Parab Shubhescha
H. NO. 54 Gaonkarwada, Pissurlme, Sattari - 403 530, Goa
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_2533_22
Penetrating ocular injuries following direct impact of fish are rare. A 26-year-old man presented to the emergency department with history of pain and blurring of vision following injury to the left eye due to the impact of glass perchlet fish. Ocular examination revealed best corrected visual acuity of log of minimum angle of resolution (logMAR) 0.18, eyelid edema, blepharospasm, and circumcorneal congestion. A full-thickness corneal laceration measuring 3 mm, confirmed by positive Seidel's test, and a partial-thickness corneal laceration measuring 1.5 mm were noted. Patient was managed by application of cyanoacrylate glue and bandage contact lens. We report the first case of corneal perforation by glass perchlet fish.
Keywords: Corneal perforation, glass perchlet, protective eyewear, Seidel's test
How to cite this article:
Shubhescha S P, Ugam P S, Ravina N. A rare case of corneal perforation with glass perchlet fish. Indian J Ophthalmol Case Rep 2023;3:304-5 |
Glass perchlet is a species of freshwater fish that belongs to the Asiatic glassfish family Ambassidae of the order Perciformes. The elongated glassy perchlet reaches a maximum total length of 11 cm. The species inhabits both fresh and blackish water and is found in canals, ponds, streams, and flooded rice paddies. This fish is harvested and sold for food in local markets. Ocular trauma is a leading cause of blindness and visual morbidity. Sports- and recreation-related eye injury accounts for more than 6,00,000 cases per year.[1] Corneal perforation is an ophthalmic emergency requiring immediate intervention.
| Case Report | |  |
A 26-year-old male presented to the emergency department with history of pain and blurring of vision following injury to the left eye due to the impact of glass perchlet fish jumping out of water while he was fishing. Ocular examination of the left eye revealed best corrected visual acuity of log of minimum angle of resolution (logMAR) 0.18, eyelid edema, and blepharospasm. Slit-lamp examination revealed circumcorneal congestion and two corneal lacerations [Figure 1]. A full-thickness corneal laceration measuring 3 mm in size, located 3 mm away from the inferior limbus (black arrow), confirmed by positive Seidel's test, and a partial-thickness corneal laceration meas uring 1.5 mm in size, located 2 mm away from the inferior limbus (red arrow) were noticed. Anterior chamber depth was minimally shallow without any reaction. Rest of the anterior segment was unremarkable. Right eye best corrected visual acuity was logMAR 0.00 and rest of the ocular examination was within normal limit. Patient received broad-spectrum intravenous antibiotics. The tear was sealed by application of N-butyl-2-cyanoacrylate glue (XOIN) and nesofilcon A bandage contact lens measuring 14 mm (Bausch and Lomb). Topical moxifloxacin eyedrops (0.5%) one hourly, natamycin eyedrops (5%) four times a day, Atropine eyedrops (1%) three times a day. Patient was lost to follow up. | Figure 1: Clinical photograph showing 3-mm full-thickness laceration (black arrow) and 1.5-mm partial-thickness laceration (red arrow)
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| Discussion | | |
Direct injury by fish usually causes blunt ocular trauma. Thakker and Usha[2] reported a case of penetrating globe injury due to needlefish. Penetrating ocular injuries are commonly associated with fishing equipment, but the one due to direct impact of fish as found in our case is rare. Alfaro et al.[3] reported that in 35 cases of open globe injuries, 51.43% were caused by fish hooks, 28.57% cases were caused by fishing weights, 8.57% of cases were caused by lures, and the mechanism was not known in 11.43% of cases. Bystanders accounted for 24.48% of the cases of fishing-related ocular injury.[3] Possible mechanism of injury in our case could either be due to fish fin or fish teeth. Early application of cyanoacrylate glue aids in the management of small corneal perforations.[4] It prevents re-epithelization into damaged stroma, thus preventing collagenase production that leads to stromal melting.[4] It also has significant bacteriostatic activity against Gram-positive organisms.[4] The benefit increases when combined with bandage contact lens. Prevention of fishing-related eye injuries can be achieved by increasing public awareness of the dangers posed by fishing. Protective eyewear reduces the risk of eye injury by 90%.[3]
| Conclusion | | |
Protective eyewear should be worn by both the active participant as well as the bystander. Small tears can be managed by sutureless methods, like the use of cyanoacrylate glue with bandage contact lens as in our case. Even minor ocular injury requires immediate medical attention.
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. | Mishra A, Verma AK. Sports related ocular injuries. Med J Armed Forces India 2012;68:260-6.  |
| 2. | Thakker MM, Usha KR. Orbital foreign body and ruptured globe from needlefish impalement. Arch Ophthalmol 2006;124:284. doi: 10.1001/archopht. 124.2.284. |
| 3. | Alfaro DV 3 rd, Jablon EP, Rodriguez Fontal M, Villalba SJ, Morris RE, Grossman M, et al. Fishing-related ocular trauma. Am J Ophthalmol 2005;139:488-92. |
| 4. | Vote BJ, Elder MJ. Cyanoacrylate glue for corneal perforations: A description of a surgical technique and a review of the literature. Clin Exp Ophthalmol 2000;28:437-42. |
[Figure 1]
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