Severe penetrating eye trauma caused by fish pick accidents.

PURPOSE AND

METHODS

The authors describe three cases in which commercial fishermen presented with penetrating ocular injuries from fish picks, which are hand-held, fish-sorting tools with relatively blunt tips designed to partially penetrate fish and expedite handling. Ocular injuries from this tool have not been reported previously.

RESULTS

Presenting visual acuity was light perception in two cases and hand motions in one case. Corneal laceration and vitreous hemorrhage were seen in all cases. Initial ultrasound showed no retinal detachment, and all patients underwent primary repair of the corneal laceration. However, within the first 2 months, follow-up ultrasound was suggestive of retinal detachment in all cases, and pars plana vitrectomy was performed. One patient who was found to have a retinal hole but no retinal detachment did well, with a visual acuity of 20/80. Two patients with retinal detachment did poorly, one with a dense epiretinal membrane and the other with a chronic irreparable retinal detachment and extensive subretinal fibrosis.

CONCLUSIONS

These injuries differ from fish hook injuries because the instrument is much larger and is blunt in nature, imparting significant energy into the eye. Consequently, patients with these injuries have a much less favorable outcome.