One of my patients is a very keen recreational fisher. How should I best advise him about the ocular dangers of fishing?

Recreational fishing, also known as angling, is a very popular activity throughout the world. However, it does come with ocular dangers. The most obvious of these is ocular trauma. Aside from penetrating injuries most often caused by fishhooks, many injuries result from weights, lures, and rods impacting one eye. Interestingly, one study showed that almost 25% of ocular trauma due to fishing occurred in bystanders.

Other eye problems come from the glare off the surface of the water. While this will not cause permanent vision loss it can cause ocular discomfort, affect the fisher’s ability to fish and therefore reduce enjoyment. It may also lead to blunt or penetrating ocular trauma because dazzle from the glare may lead to the ill-judged casting of the weight and hook. As mentioned above this type of ocular trauma may involve a bystander.

Being outside in the sun can lead to exposure to high levels of UV and blue light; the former has been linked with cataract, pingueculae and pterygium formation while blue light exposure over many years may result in age-related macular degeneration.

People who take part in recreational fishing are also at risk of fungal infection. The most common way for someone to get a fungal eye infection is because of an eye injury, particularly if plant material such as a stick or a thorn caused the injury. Some fungi that cause eye infections, such as Fusarium, live in the environment and are often associated with plant material. Fungi can enter the eye and cause infection after an injury.

Weil’s disease is a form of a bacterial infection also known as Leptospirosis that is carried by animals, most commonly in rats and cattle. It can be caught by humans through contact with rat or cattle urine, most commonly occurring through contaminated fresh water. Although human infection in the UK is minimal it is still worth taking some preventative measures to decrease the possibility of contracting it. It can cause jaundice (yellow eyes) and red eyes. Preventative measures can be taken:

• Cover any open wounds such as cuts and scratches with waterproof plasters.
• Wear protective clothing such as gloves.
• Wash thoroughly and as soon as possible if you have entered the water.
• Be aware of stagnant water.
• Carefully clean any open wounds obtained during the time at freshwater.

Patients who fish should be offered eye protection. If they have a refractive error for distance and/or near vision then consider some form of multifocal and a combination of polycarbonate lenses with a polarising and photochromic element. If they don’t need refractive correction then off-the-shelf polycarbonate, polarising, photochromic will do a good job.