Needlefish jaw in the orbit

: We report a case of unsuspected penetrating trauma with intraorbital foreign body, namely a needlefish jaw. A 44-year-old fisherman presented with vertical diplopia and discrete swelling of the upper lid near the medial canthus after being hit by a fish. He was unaware of any penetrating lesion or foreign body. There was no entry wound. CT-scan showed a foreign body between the globe and the medial orbital wall. Surgical exploration found that it was a 4.5cm long needlefish jaw. Removal resulted in complete resolution of symptoms. Needlefish can be very dangerous. This is the first reported case of a needlefish jaw in the orbit with no associated lesion, infection or inflammation.