|Year : 1961 | Volume
| Issue : 3 | Page : 68-69
Intra-ocular fish bone- a case report
S Nazre Imam
|Date of Web Publication||7-Apr-2008|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Imam S N. Intra-ocular fish bone- a case report. Indian J Ophthalmol 1961;9:68-9
It is a story of a small fish bone lying within an eye ball for 20 years.
Tegh Narayan, a Hindu male aged 33 years visited the doctor for the deviation of his right eye which had lost sight for nearly 20 years.
History revealed that he had an injury while fishing when his companion hooked a fish in a pond at Dinapure (Bihar). He had lot of instantaneous bleeding from eye subsequently followed by intense pain and tenderness. He was locally treated by a doctor for a few days after which his troubles were gone but unfortunately along with the sight of his right eye. A few days later a team of his relatives were leaving for Singapore on business account with whom he too left home, reached Singapore and got absorbed, in laundry business little caring for the blind eye.
He used to return home and leave again for Singapore at intervals of several years but did never care to see an eye specialist partly because he had no trouble, partly because he and his relatives did not expect any improvement.
In the homeward trip of 1959 he saw me along with a brother of his for the latter's refraction when I could detect his deviated eye with white pupil and enquired how this came about. He told the above story in brief and casually asked whether anything could be done to bring back his sight.
Local Examination: After his brother's examination was over I looked into his eye and found that his affected eye was perfectly quiet, but lead a cataractous lens with PL & PR present and with normal tension.
Diagnosis : I diagnosed the case as traumatic cataract and advised him operation which might take two stages. He readily agreed.
Treatment : He was taken in the ward of Patna Medical College Hospital, and you would be glad to know on the side of the President of this Conference, Dr. Dukhan Ram whose resident officer and assistant I was at that time.
Operation : Whatever knowledge and experience I had of the speciality and whatever courage and confidence I could gather under the patronage of Dr. Ram, I decided to do Needling. I did it but without much meddling for that was my guru's golden rule "not to meddle much, play about, or show off when you are within the eye ball". Eye was bandaged and daily dressings were done in the normal way. On the second day and subsequent days the vision was C.F. at a distance of ½ meter. He was discharged on the seventh day. But he continued coming and all the time telling to operate again as I had told him in 'the beginning about the two stages. Moreover, now alter the operation,, he was much more concerned with the "bad white pupil" than ever before. Although the whiteness had become dim.
He was again taken in alter six weeks and this time I took the boldness of Dr. Para: Nath Sinha and did the Currette-evacuation. To my great delight the eye was perfectly quiet in 12 days time, with the usual vision of aphakic eyes, and the patient was asked to come back after a month or so for glasses.
But just alter a week the man came with a complaint of pain in the eye. On examination I discovered a vesicle of about 1.5 mm diameter opposite 9 o'Clock just outside he limbus. A colleague of mine pointed it out to be a source of sepsis and I became very nervous and immediately saw my professor, Dr. Ram in order to make him share the responsibility in the eye of a patient. He asked me to prick it with all sterilised technique and keep him under observation. I had started doing accordingly but just when I tried to prick the thing it felt hard, then I took a pair of plain conjunctival forceps and tried to crush it but instead the length of the so called vesicle increased and on pulling further towards my side a white hard slender thing 8 mm long came out. On close inspection it proved to be a fish bone with its typical minute serrations bent on one side just as one finds it in the throat when a patient comes to the Emergency Room with a fish-bone impacted in tonsils or Pyriform fossae.
After that the patient's eye has always been quiet. He has worn glasses with 6/18 result and often written from Singapore giving me all sorts of compliments.
Ladies and gentlemen, this is how a fish-bone got inside the eyeball during fishing, remained there quietly for 20 years in the company of a traumatic cataract and got out quietly only after its 20 year companion was no more, leaving the eye-ball in peace and without any further complication