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JAMA Ophthalmology Clinical Challenge |

Penetrating Ocular Fishhook Injury QUIZ

Daniel L. Chao, MD, PhD1; Benjamin P. Erickson, MD1; Aleksandra V. Rachitskaya, MD1
[+] Author Affiliations
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
JAMA Ophthalmol. 2015;133(3):347-348. doi:10.1001/jamaophthalmol.2014.4778.
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Figure 1.

External photograph showing a 3-pronged treble hook lodged in the cornea and lower eyelid; visual acuity is hand motions.

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Figure 2.

A, Treble hook (left), barbed fishhook (center), and double-barbed fishhook (right). B, Back-out technique, in which the fishhook is rotated retrogradely through the wound. C-E, Advance-and-cut technique: the fishhook is rotated anterogradely through exit wound, the barb is cut, and the fishhook is rotated retrogradely through entry wound.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Video.

To remove the 3-pronged barbed fishhook using the cut-and-push-through technique, the contaminated lure is cut before transferring the patient to the operating room. The anterior chamber is inflated with viscoelastic, and the exit wound is fashioned to rotate out the barbed fishhook lodged in the anterior chamber. The barbed prong of the fishhook lodged in the lower eyelid is dissected using blunt Westcott scissors and then removed.

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