Self-inflicted transorbital intracranial foreign body following ingestion of hallucinogenic psilocybin mushrooms.
Abigail M Blanton, Pooja Parikh, Scott Zhou, Mohamed Mohamed, Rafael L Ufret-Vincenty, Ronald Mancini
American journal of ophthalmology case reports September 1, 2025 DOI: 10.1016/j.ajoc.2025.102359 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 21-year-old Hispanic male |
| Interventions | fluoroscopy-guided neuro-interventional catheterization and stenting canthotomy/cantholysis |
| Topics | Psilocybin |
| Keywords | Neurosurgery Ocular trauma Transorbital foreign body Eye injury Orbital injury Severe eye damage Vision trauma Brain surgery Surgical intervention Cranial surgery Orbital surgery Medical procedure Psilocybin complications Drug-related injury Substance-induced trauma Psychedelic effects Drug ingestion complications Fatal injury Fatal outcome Life-threatening injury Mortality Terminal injury Death |
| Citations | 3 |
| Key findings | Self-inflicted transorbital pencil injury after psilocybin ingestion led to brainstem damage and death despite successful foreign body removal. |
Abstract
Self-inflicted penetrating orbital trauma is a rare ophthalmologic emergency requiring timely intervention and neurological monitoring to identify and treat any possible intracranial complications and to prevent irreversible vision loss. This case report aims to describe a fatal case of self-inflicted ocular trauma following the consumption of psilocybin mushrooms, necessitating urgent multidisciplinary care by the ophthalmology and neurosurgery services. A 21-year-old Hispanic male presented urgently to the emergency department (ED) after self-inflicted ocular trauma with a wood-cased pencil, which was embedded in the upper eyelid and transversed the left orbit, extending to the pons, as depicted on computed tomography (CT). Physical examination of the left eye was difficult due to the risk of displacement of the pencil within the brainstem and concern for further damage. The pencil was successfully removed via fluoroscopy-guided neuro-interventional catheterization and stenting. Following the removal of the foreign body, there was no apparent damage to the globe, and a canthotomy/cantholysis was performed due to increased retro-orbital pressure. The neurovascular damage sustained by the trauma led to a progressive neurological decline in the following days and, ultimately, a fatal outcome. With growing support in the literature for psilocybin and its therapeutic medicinal benefits for conditions such as depression and anxiety, this report details a case of self-inflicted trans-orbital trauma with brainstem injury following ingestion of this psychoactive hallucinogen along with the proper medical and surgical management.
Comparable studies
Other case reports and case series on psilocybin, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psilocybin Mushroom (Psilocybe semilanceata) Intoxication with Myocardial Infarction 18-year-old man | 1998 | Case study | n = 1 |
| Relief from intractable phantom pain by combining psilocybin and mirror visual-feedback (MVF) Person with leg amputation and phantom-limb pain | 2018 | Case study | n = 1 |
| Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication | 2005 | Case study | n = 1 |
| Microdosing psilocybin for chronic pain: a case series Individuals with chronic neuropathic pain | 2022 | Case series | n = 3 |
| Psilocybin and Obsessive Compulsive Disorder Individual with Obsessive Compulsive Disorder | 2014 | Case study | n = 1 |
Citations in the library
Cited by 2
- Naturally Derived Psilocybin for Therapeutic Use: A Six-Criterion Framework for Evidence, Safety, and Benefit–Risk Considerations in Policy and Clinical Development Biomolecules July 3, 2026
- If you respect someone, let them go? Personal autonomy and physical safety in psychedelic treatments JME Practical Bioethics July 1, 2026
Cites 37
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
and 32 more in the library