Fishing Hook Globe Injury Diagnosed with Point-of-care Ultrasound: A Case Report

Introduction: Globe injuries constitute true ophthalmologic emergencies and require prompt surgical intervention. When direct physical examination is limited, due to trauma or swelling, point-of-care ultrasound (POCUS) can serve as a valuable adjunct in evaluating globe integrity. Case Report: We report the case of a 31-year-old male who presented to the emergency department with a barbed fishing hook embedded in his right eyelid. The patient reported pain localized to the eyelid but denied any visual disturbances or direct eye involvement. On examination, a large fishing hook embedded in the right upper eyelid was visualized. His eye was swollen, and he was unable to fully open it, limiting direct assessment of the globe. Given the limited exam, POCUS of the right eye revealed a foreign body traversing the anterior chamber toward the lens, raising concern for globe injury. Ophthalmology was consulted, and computed tomography of the orbits was obtained. The following morning, the patient underwent surgical removal of the barbed fishing hook and repair of the globe. Conclusion: Point-of-care ultrasonography is a valuable diagnostic adjunct in the evaluation of traumatic eye injuries and useful when physical examination is limited. In this case, POCUS was used to differentiate an intraocular foreign body and globe injury from eyelid foreign body. While POCUS is not routinely recommended in cases of suspected globe rupture, when physical exam is unclear it may be a useful adjunct.