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| PHOTO ESSAY |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 535-536 |
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No trap so deadly as your own trap – Fish hook injury of the eyelid
Ranjan Ponnusamy Chandrasekaran1, Prasanna Venkatesh Ramesh2, Niranjan Karthick3, Shruthy Vaishali Ramesh4, Aji Kunnath Devadas5
1 Director, Annai Eye Hospital, Ramanathapuram, Tamil Nadu, India
2 Medical Officer, Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
3 Fellow, Department of Comprehensive Ophthalmology, Nirmal Eye Hospital, Chennai, Tamil Nadu, India
4 Medical Officer, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
5 Consultant Optometrist, Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
| Date of Submission | 10-Oct-2022 |
| Date of Acceptance | 20-Dec-2022 |
| Date of Web Publication | 28-Apr-2023 |
Correspondence Address:
Prasanna Venkatesh Ramesh
Mahathma Eye Hospital Private Limited, No. 6, Tennur, Seshapuram, Trichy - 620 017, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_2649_22
Keywords: Fish Hook, Trauma, Trap, Fishing, Occupational Hazard
How to cite this article:
Chandrasekaran RP, Ramesh PV, Karthick N, Ramesh SV, Devadas AK. No trap so deadly as your own trap – Fish hook injury of the eyelid. Indian J Ophthalmol Case Rep 2023;3:535-6 |
How to cite this URL:
Chandrasekaran RP, Ramesh PV, Karthick N, Ramesh SV, Devadas AK. No trap so deadly as your own trap – Fish hook injury of the eyelid. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Jun 2];3:535-6. Available from: https://www.ijoreports.in/text.asp?2023/3/2/535/374964 |
Fishing has been and continues to be a popular pastime among various segments of a global society. The fish hook has been infamous for the varied varieties of injuries it can cause to the body. Ocular injuries can especially prove disastrous to one's vision and anatomical structures. A varied presentation of such injuries has been reported. We report one such case of fish hook injury to the eyelid with its management. We discuss here the various techniques which can be used to remove a fish hook from ocular structures, albeit following utmost safety.
A 10-year-old boy was brought to the emergency department with a lodged fish hook in his right upper lid. He was a bystander who had accompanied his friend fishing. Accidentally, while pulling the hook in response to the fish nibbling the bait, the hook got impinged onto his right upper lid, with the bait stuck between the hook and the nylon wire [Figure 1]. The anterior and posterior segment evaluations were normal, besides the lid injury. Under local anesthesia, a small nick was made near the hook to let out the barb and remove the hook [Figure 2]. The wound was minor, and hence, was allowed to heal with secondary intention under antibiotic cover. | Figure 1: Image showing a bait-loaded fish hook embedded in the medial part of the right upper lid
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| Discussion | |  |
A typical fishing hook consists of an eye, a shank, a bend, a gape, a bite, a point, and a barb.[1] Its sharp barbed tip is notorious for causing injuries to humans. Interestingly, not only those fishing but also innocent bystanders have been victimized by this perilous tool.[2]
Though fish hook injuries are rare, there are cases reported where the hook piercing the cornea has caused corneal edema and hyphema.[3] These injuries can also be associated with corneal lacerations, traumatic cataracts, and so on. The usual aftermath of these corneal injuries is corneal scarring. Choroidal hemorrhage, vitreous hemorrhage, retinal tears, retinal detachments, and endophthalmitis are other posterior segment complications reported due to fish hook injury.[4]
Management of fish hook injuries is a tricky one. The hook is must be detached from the wire without meddling with the wound. Any inexperienced attempts by untrained personnel can further result in devastating complications. Several techniques have been advocated. The back-out method involves backing the hook through its entrance wound, but it is only safe for a barbless hook. In the advance and cut method, a controlled surgical exit wound is created to allow delivery of the barb, which is then cut off at the bend with sterile wire cutters, after which the remaining barbless hook is easily removed using the back-out technique. The needle cover technique uses a wide-bore needle to encompass the hook with the barb in cases of perforating retinal injuries before taking it out.[5],[6],[7] Each injury needs to be managed in a customized manner, depending on the structures involved and the type of hook used.
Declaration of 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. | Edappazham G, Thomas S, Bharathiamma M, Ashraf M. Physical and mechanical properties of fishing hooks. Mater Lett 2008;62:1543-6.  |
| 2. | Alfaro DV, Jablon EP, Fontal MR, Villalba SJ, Morris RE, Grossman M, et al. Fishing-related ocular trauma. Am J Ophthalmol 2005;139:488-92. |
| 3. | Ahmad SS, Seng CW, Ghani SA, Lee JF. Cut-it-out technique for ocular fish-hook injury. J Emerg Trauma Shock 2013;6:293-5. [ PUBMED] [Full text] |
| 4. | Kalyanasundaram TS, Depla D, Steel D. An unusual case of severe penetrating ocular injury with the shank of a triplet fish hook. Eye 2003;17:663-4. |
| 5. | Mandelcorn MS, Crichton A. Fish hook removal from vitreous and retina. Case report. Arch Ophthalmol 1989;107:493. |
| 6. | Hung SO, Smerdon D. Eyeball injury due to fish hook. J Trauma 1984;24:997-8. |
| 7. | Grand MG, Lobes LA. Technique for removing a fishhook from the posterior segment of the eye. Arch Ophthalmol 1980;98:152-3. |
[Figure 1], [Figure 2]
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