Egocentric human-object interaction (Ego-HOI) detection is crucial for intelligent agents to understand and assist human activities from a first-person perspective. However, progress has been hindered by the lack of benchmarks and methods tailored to egocentric challenges such as severe hand-object occlusion. In this paper, we introduce the real-world Ego-HOI detection task and the accompanying Ego-HOIBench, a new dataset with over 27K egocentric images and explicit, fine-grained hand-verb-object triplet annotations across 123 categories. Ego-HOIBench covers diverse daily scenarios, object types, and both single- and two-hand interactions, offering a comprehensive testbed for Ego-HOI research. Benchmarking existing third-person HOI detectors on Ego-HOIBench reveals significant performance gaps, highlighting the need for egocentric-specific solutions. To this end, we propose Hand Geometry and Interactivity Refinement (HGIR), a lightweight, plug-and-play scheme that leverages hand pose and geometric cues to enhance interaction representations. Specifically, HGIR explicitly extracts global hand geometric features from the estimated hand pose proposals, and further refines interaction features through pose-interaction attention, enabling the model to focus on subtle hand-object relationship differences even under severe occlusion. HGIR significantly improves Ego-HOI detection performance across multiple baselines, achieving new state-of-the-art results on Ego-HOIBench. Our dataset and method establish a solid foundation for future research in egocentric vision and human-object interaction understanding. Project page: https://dengkunyuan.github.io/EgoHOIBench/