Severe fishhook-related ocular injury: A case series

This study examined the treatment, clinical course, and prognosis of two patients who visited our institution with severe ocular fishhook-related injuries with complications. The first patient was a 57-year-old man injured in the right eye by a fishhook lacerating the right upper eyelid. Although no aqueous humor leakage was observed, intraocular hemorrhage was severe, and the best-corrected visual acuity (BCVA) was “counting fingers” at 15 cm. The eyelid was sutured and vitreous surgery with cataract surgery was performed for traumatic cataract, vitreous hemorrhage, and retinal detachment. The patient experienced recurring iritis and the BCVA recovered to 20/100 eight months postoperatively. The second patient was a 62-year-old man who incurred a penetrating right-eye fishhook injury on a ship with BCVA of “hand motion.” The sclera and iris were ruptured with severe hemorrhage and a shallow anterior chamber without leakage of aqueous humor. A damaged lens and vitreous hemorrhage were observed with intraocular pressure of 38 mmHg. The ruptured sclera was sutured and vitreous surgery with lensectomy was performed. After 16 months, the BCVA improved to 20/40; however, glaucoma control was maintained by topical medication. Therefore, ocular fishhook-related injury could result in irreversible visual impairment. It is important to pay attention and protect the eyes from moving fishhooks during fishing. PLAIN LANGUAGE SUMMARY: There are few reports on fishhook injury of the eye with resulting complications such as retinal detachment. We present the characteristics of the injury, treatment, clinical course, and prognosis of two patients with severe fishhook-related injuries of the eye with complications. Following treatment, most complications, including vitreous hemorrhage, detached lens, and retinal detachment, safely resolved in these cases; however, both patients required further treatment for recurring inflammation of the iris or glaucoma. The visual acuity of both patients improved over several months. Fishhook-related injuries of the eyes might result in irreversible visual impairment. It is important to pay attention and protect the eyes from moving fishhooks during fishing.