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Medicine riddle: What doctors found in the eye of the traveler


Eye discomfort after a bathing accident - mysterious objects have entered the eye socket
Holidays are supposed to be used for rest and relaxation, but some travelers experience mysterious complaints that accompany them from far away countries. So is a man who developed serious eye problems after a supposedly harmless bathing accident in Egypt. What the doctors at the Freiburg University Medical Center found in his eye also surprised them.

The man had spent his vacation on the Red Sea in Egypt and had taken off his goggles while snorkeling. Something collided with his left eye, which hurt and bleed slightly. But the initial complaints went back quickly and at first everything seemed normal. However, there was still something wrong with the eye after his return, which is why the man visited the Ophthalmology Clinic of the University Medical Center Freiburg. There, the doctors were only able to determine the actual cause within the scope of an operative intervention, which none of the participants had expected in the end.

Double images and drooping eyelid
The patient could not see exactly what had collided with his eye while diving, according to the Freiburg University Hospital. Although the eye bled and hurt for a short time, the complaints quickly resolved. But the eye continues to cause complaints to the man, which is why he came to the Ophthalmology Clinic of the University Medical Center Freiburg four weeks after the bathing accident. According to Professor Dr. Wolf Lagrèze, head of the neuro-ophthalmology, pediatric ophthalmology, squint treatment department at the Freiburg University Hospital and head of the Freiburg Orbita Center, was able to "only open the right eyelid about half" and "he also saw double images like squinting when looking up . "

Suspected granuloma
In the Freiburg Orbita Center, where experts from a total of eleven departments work together to optimally treat diseases and injuries to the eye socket, an unusual, rounded, scarred area on the left upper eyelid was palpable during the first examination. Professor Lagrèze "initially suspected that it was a benign nodule or a small scar," according to the university clinic. But "you didn't see anything unusual in the MRI images, just a knot in the eyelid tissue," says Professor Lagrèze.

Foreign objects resemble small straws
In an intervention under local anesthesia, the team led by Professor Lagrèze then tried to remove the alleged granuloma. But "when we cut the scar, we discovered a dark blue-greenish foreign body," reports the doctor. After consultation with the patient, general anesthesia was therefore initiated to continue the operation. "As we continued to prepare the scar, two objects appeared that looked like straws at first and reached deep into the eye socket," Professor Lagrèze continued.

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

Hitting a fish
According to Professor Lagrèze, the patient "apparently collided with the fish, with the lower jaw bones above the eyeball penetrating and breaking off in the eye socket." An extremely unpleasant idea, although the complaints were initially limited. "How two pins (the bones) fixed the lifting muscle of the eyelid and the muscle for upward movements of the eye," explains the expert. Because only the right eye could move when looking up, the double images had occurred. The injury to the eye was completely healed three months after the procedure and "there is nothing to be said against future snorkeling tours," says Professor Lagrèze. (fp)

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