Ocular Fish Hook Injuries

Fishing stands out as a widely enjoyed leisure pursuit. While ocular fishing injuries are infrequent, they carry the potential for severe ocular trauma, and safe extraction of a fish hook can pose challenges. We here in report a series of 21 cases of penetrating injury to the cornea by fish hook, detailing successful surgical interventions employed for their management. The report not only outlines different techniques for the removal of fish hooks but also provides clarification on terminologies associated with various components of a fish hook.

This was a retrospective study conducted at tertiary eye care centers in South India. Our hospitals cater to the states of Telangana, Andhra Pradesh, and Odisha. All medical records of patients who attended the emergency department from the period of 2003 to 2023 were evaluated and all patients with fish hook injury were included in the study. 

    A total number of twenty-one cases of ocular fish-hook injuries were identified. Patients were followed up at postoperative day one, post-operative one-week, post‑operative one month, and every three months for the first year and every six months after that duration. Comprehensive eye examination and necessary investigations in the follow‑up visit had been performed in all these patients. Age, Sex, occupation, preoperative best corrected visual acuity (BCVA), post-operative BCVA, slit lamp examination, B scan ultrasonography further surgical procedures, surgical technique, last follow-up BCVA, outcome, and years of follow-up were studied (Table 1). This is the largest study in the literature.

Patients were between the ages of 9 and 59 years (mean, 29.4 years), and 90.4% (19 out of 21) were males. Out of 21 cases, 3 cases (14.3%) had blunt trauma and 17 cases (80.9%) had penetrating injury. Patients had better visual outcomes after the second surgery. Out of 21 cases, 7 (33.3%) had post-operative visual acuity (VA) between 20/20 and 20/40. Three (14.3%) had post-operative VA between 20/60 and 20/125. Five (23.8%) had post-operative VA between 20/200 and 20/600. Six cases (28.6%) had poor visual outcomes of which two had no perception of light (NPL), two had Hand movements and the other two had the perception of light present and projection of rays inaccurate

This extensive case series underscores the complexity of ocular injuries caused by fish hooks and emphasizes significance of tailored surgical approaches for optimal visual outcomes. The hook can be successfully removed with minimal trauma to ocular structures by understanding structure of fish hook and by employing appropriate method of extract