OPRS Images
Orbital Injury From Needlefish Impalement Asghar Haider, B.S.*, Don S. Minckler, M.D*†, Marc A. Yonkers, M.D., Ph.D.*†, and Jeremiah P. Tao, M.D.*† *Gavin Herbert Eye Institute, Irvine, California, U.S.A.; and †Irvine School of Medicine, University of California, Irvine, California, U.S.A.
FIG. 2. (A) Photograph of foreign cartilaginous material removed from the left orbit of the patient. (B) A 20.5x magnified photomicrograph from the boxed portion of (A). FIG. 1. (A) Photograph of a needlefish courtesy of John T. Snow, www.mexfish.com. (B) Coronal and (C) sagittal CT images showing hyperintense lesions indicated by white arrows.
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hrough the medial bulbar conjunctiva, a needlefish (Fig. 1A) beak impaled the orbit of a 28-year-old man surfing in South America. He was initially treated conservatively with removal of subconjunctival and anterior orbital foreign material. Progressive eye irritation and pain prompted CT that demonstrated nonspecific hyperintense lesions (arrows) in the deep
Accepted for publication December 9, 2014. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Asghar Haider, B.S., 850 Health Sciences Road, Irvine, CA 92697-4375. E-mail: [email protected] DOI: 10.1097/IOP.0000000000000400
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superior orbit (Fig. 1B) coronal and (Fig. 1C) sagittal images. After a superior orbitotomy through an eyelid crease incision, 19 fragments of foreign cartilaginous material were removed, shown in an unmagnified gross photo (Fig. 2A). A 20.5× magnified photomicrograph (Fig. 2B) demonstrates finer detail from the boxed portion of Fig. 2A. The needlefish, of the family Belonidae, has a long teeth-studded beak and a slender body capable of growing up to 2 meters. This anatomy enables needlefish to leap and skip at speeds of up to 40 miles per hour across the water surface. Needlefish rarely cause facial trauma, and more commonly injure extremities and the trunk. While infrequent, facial needlefish injuries have been associated with disfigurement, facial paralysis and death; vigorous irrigation, debridement and tetanus prophylaxis may forestall secondary infections. Ophthal Plast Reconstr Surg, Vol. 31, No. 6, 2015
Orbital Injury From Needlefish Impalement Asghar Haider, B.S.*, Don S. Minckler, M.D*†, Marc A. Yonkers, M.D., Ph.D.*†, and Jeremiah P. Tao, M.D.*† *Gavin Herbert Eye Institute, Irvine, California, U.S.A.; and †Irvine School of Medicine, University of California, Irvine, California, U.S.A.
FIG. 2. (A) Photograph of foreign cartilaginous material removed from the left orbit of the patient. (B) A 20.5x magnified photomicrograph from the boxed portion of (A). FIG. 1. (A) Photograph of a needlefish courtesy of John T. Snow, www.mexfish.com. (B) Coronal and (C) sagittal CT images showing hyperintense lesions indicated by white arrows.
T
hrough the medial bulbar conjunctiva, a needlefish (Fig. 1A) beak impaled the orbit of a 28-year-old man surfing in South America. He was initially treated conservatively with removal of subconjunctival and anterior orbital foreign material. Progressive eye irritation and pain prompted CT that demonstrated nonspecific hyperintense lesions (arrows) in the deep
Accepted for publication December 9, 2014. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Asghar Haider, B.S., 850 Health Sciences Road, Irvine, CA 92697-4375. E-mail: [email protected] DOI: 10.1097/IOP.0000000000000400
e170
superior orbit (Fig. 1B) coronal and (Fig. 1C) sagittal images. After a superior orbitotomy through an eyelid crease incision, 19 fragments of foreign cartilaginous material were removed, shown in an unmagnified gross photo (Fig. 2A). A 20.5× magnified photomicrograph (Fig. 2B) demonstrates finer detail from the boxed portion of Fig. 2A. The needlefish, of the family Belonidae, has a long teeth-studded beak and a slender body capable of growing up to 2 meters. This anatomy enables needlefish to leap and skip at speeds of up to 40 miles per hour across the water surface. Needlefish rarely cause facial trauma, and more commonly injure extremities and the trunk. While infrequent, facial needlefish injuries have been associated with disfigurement, facial paralysis and death; vigorous irrigation, debridement and tetanus prophylaxis may forestall secondary infections. Ophthal Plast Reconstr Surg, Vol. 31, No. 6, 2015
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