Barbed Fish Hook Injury Of The Eye Causing Corneal Perforation And Traumatic Cataract-Management Strategies And Prevention.

To describe  potential risks and successful management of  a rare barbed fishhook injury to the eye causing corneal perforation and traumatic cataract and disseminate information to the public about the possible dangers of fishhook injuries and their prevention.

A 42 year old fisherman while trawling  sustained   barbed fishook injury,followed by loss of vision.On examination the hook was found to be embedded in the eyelid causing ragged corneal tear  in the right eye.Furthermore,a large anterior capsular tear was noticed with total  trauamatic cataract and vitreous in the wound.Fishhook was entangled between both the eyelids.Visual acuity was hand motions and projection intact in the injured eye. 

A surgery was planned under GA. The fishhook was disentangled from the eyelids and cornea  repaired with 10-0 nylon sutures both continous and interrrupted as the wound was ragged and  highly irregular making suturing challenging  ,followed by cataract removal ,along with anterior vitrectomy and scleral fixated IOL.Patient was discharged the next day and  precribed systemic antibiotcs and steroids for few days post operatively.Next day his visual acuity was 3 metres  and fundus was found to be normal.

Patient was followed up every two weeks for 22 weeks  and is still on a follow up .On every visit ,his visual acuity was found to improve and after suture removal on tenth week  the final  best corrected visual acuity of 6/12p was attained which is still stable on present follow up.There is no vitreous in the wound and AC looks quiet.He is presently on no medication.

Fish hook injuries are rare but dangerous to the eye ,frequenting  causing  devastating accidents.Barbed hook injuries are even rarer and have to be managed with dexterity and patience as dislodgment might take lot of time and expertise.Timely and meticulous care is required to handle these emergencies and the fishermen have to be educated about the potential  grievous  nature of the injuries and informed to be more careful of themselves as well as bystanders.