An Extreme Case Of Ocular Fish Hook Injury

An Extreme Case Of Ocular Fish Hook Injury.

An 11-year-old boy was referred to our clinic with a history of injury to the right eye while fishing the day before!! Apparently while pulling the line, the fish-hook flew to the patient's right eye and got embedded in the cornea. Someone had cut the line and the dangling hook was taped to the cheek and. The patient was received by us in this condition.

On examination, the visual acuity was a perception of light; with projection accurate in all quadrants in the affected right eye and 20/20 unaided vision in the left eye. The fish-hook had penetrated the cornea and impaled itself in the deeper tissues. There was a settled hyphema and the deeper tissues were obscured by it and corneal edema.

The hook was pulled back toward the cornea. The point of entry was enlarged with a 15° slit knife. The same knife was then pushed in along the shank until the barb could be felt near the cornea. This was then used to guide the fish-hook out of the eye. Subsequently, the corneal laceration was sutured with 10/0 nylon. An anterior chamber washout was carried out with balanced salt solution. A subconjunctival injection of dexamethasone and gentamicin was given to complete the procedure.

At 1 week of follow-up, the eye showed minimal inflammation. The vision was still perception of light. The cornea had cleared appreciably. The damage to the iris at the pupillary margin and a traumatic cataract was visible. The parents were counseled for the need of a cataract extraction in the future.

Case reposted from @medicalpedia

Credit: Department of Ophthalmology, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia

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