Medical riddle What doctors found in the traveler's eye

Eye complaints after bathing accident - enigmatic objects penetrated into the eye socket
Actually, holidays are meant to be a rest and relaxation, but some travelers suffer mysterious complaints that accompany them from distant lands to their homes. So did a man who developed severe eye problems after a supposedly harmless swimming accident in Egypt. What the physicians of the University Hospital Freiburg found in his eye surprised them, too.

The man had spent his vacation on the Red Sea in Egypt and dropped the diving goggles while snorkeling. Something collided with his left eye, causing pain and bleeding. But the initial complaints went back quickly and at first everything seemed normal. However, even after his return, something was wrong with the eye, which is why the man went to the Department of Ophthalmology of the University Hospital Freiburg. There, the physicians were only in the context of surgery to determine the actual cause, which had expected no one of the parties in the end.

The patient suffered from massive complaints. Image: vchalup - fotolia

Double pictures and hanging eyelid
According to the University of Freiburg, the patient could not tell what exactly collided with his eye when diving. Although the eye had bled and hurt for a short time, the symptoms quickly receded. But the eye continues to cause complaints to the man, which is why he came to the Department of Ophthalmology at Freiburg University Hospital four weeks after the accident. According to Professor dr. Wolf Lagrèze, Head of the Department of Neuro-ophthalmology, Pediatric Ophthalmology, Squint Treatment at Freiburg University Hospital and Head of the Orbita Center Freiburg, the patient could "only half open the right eyelid" and "he also saw double vision as if squinting when he looked up . "

Suspected granuloma
In the Freiburg Orbita Center, where experts from a total of eleven specialist areas work together to optimally treat diseases and injuries to the eye socket, an unusual, rounded, scarred area on the left upper lid was already palpable at the first examination. Professor Lagrèze "initially suspected that it was a benign nodule or a small scar," according to the University Hospital. This so-called granuloma was examined more closely by means of nuclear spin images, with which the soft tissue of the eye can be shown in great detail. But "one did not see anything unusual in the nuclear spin images, just a knot in the lint," says Professor Lagrèze.

Foreign bodies resemble small straws
In an intervention under local anesthesia, the team led by Professor Lagrèze tried to remove the supposed granuloma afterwards. But "when we had cut the scar, we discovered a dark blue-greenish foreign body," says the physician. After consultation with the patient, general anesthesia was therefore initiated to continue the operation. "As the scar was further dissected, two objects appeared that looked like straws at first, reaching deep into the eye socket," continued Professor Lagrèze.

Objects were easily removable
Fortunately, the objects could be "pulled out relatively easily," reports the ophthalmologist and subsequently the wound was sutured to the eyelid and closed with a bandage. On closer inspection, the suspicion arose that the objects could come from a fish and there was an analysis by the Hamburg Thünen Institute of Sea Fisheries. "The scientists there identified it as the lower jaw of the half-beak, which is native in tropical waters and in shallow water directly below the water surface looking for prey," reports the Freibug University Hospital.

Collision with a fish
According to Professor Lagrèze, the patient "apparently collided with the fish, with the lower jawbones penetrating the eye socket above the eyeball and breaking off." An extremely unpleasant notion, although the symptoms were initially limited. "Like two pins (the bones) have fixed the eyelid lifting muscle and the muscle for upward movement of the eye," explains the expert. Because this only allowed the right eye to move when looking up, the double images had appeared. The injury to the eye was completely cured three months after the procedure and "nothing speaks against future snorkeling trips," says Professor Lagrèze. (Fp)