Snapshot!

Snapshot!

"The fish will eat your eyes"

A young Australian surfer visiting Bali did not heed the warning of local villagers who told him not to stay out on the lagoon at dusk or the "fish will eat your eyes". One evening, while paddling back to shore from a day's surfing, he was suddenly hit in the face by an unknown object. This produced instant and intense pain in the right orbit with subsequent periorbital cellulitis and cervical lymphadenopathy, although his vision was maintained. Oral antibiotics given by local doctors had no effect, so he flew back to Australia for medical consultation.

A computed tomography scan showed a 6cm foreign body passing along the right inferoloateral orbital floor, missing the globe and the optic nerve, but penetrating the inferior orbital fissure to terminate approximately 5mm anterior to the internal carotid artery (Figures a and b). It was surgically removed and proved to be the broken-off snout of a "javelin" or "needle" fish (Figure c). It comprised the upper and lower jaws, complete with multiple small teeth.

The patient made an excellent recovery.

Christopher J O'Donnell
Radiologist, Victorian Imaging Group
Elsternwick, VIC

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