Penetrating Ocular Fish-Hook Injury

Penetrating ocular injuries caused by fish hooks, although rare, present unique challenges and significant risks to ocular structures and vision. We report a case of a 36-year-old male who presented with a fish hook embedded in his right eye. Clinical examination revealed a fish hook perforating the cornea, entering at the nasal cornea at 3 o'clock and exiting at the temporal cornea at 7 o'clock. Despite initial attempts to employ the advance-and-cut technique, the unsuccessful utilization of a wire cutter led to a shift in the removal approach. The modified backout method was successfully employed, allowing the safe extraction of the fish hook while minimizing iatrogenic damage. Follow-up appointments showed a gradual improvement in visual acuity despite early cataract formation and significant central scarring. To optimize the patient's visual outcome, a triple procedure involving penetrating keratoplasty (PKP), extra-capsular cataract extraction (ECCE), and intraocular lens (IOL) implantation has been scheduled. This case highlights the importance of prompt and adaptable management in ocular fish-hook injuries, emphasizing the need for comprehensive follow-up care. It also underscores the value of preventive measures, including the use of protective eyewear, to reduce the incidence of such injuries, given that the majority of ocular traumas are preventable.