Ocular self-mutilation: a case series

Coussa, Razek Georges; Mikhail, Mikel; Flanders, Michael; Arthurs, Bryan

doi:10.1016/j.jcjo.2017.07.020

Cited by 3 publications

(6 citation statements)

References 13 publications

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“… 2 Substance-induced psychotic symptoms are most commonly associated with phencyclidine, lysergic acid diethylamide (LSD), cocaine, cannabis, and amphetamine use, but it has also been associated with alcohol abuse. 1 , 3 Even though our patient could have had a primary psychotic disorder, the most likely trigger of his behavior was alcohol abuse.…”

Section: Discussionmentioning

confidence: 90%

“…There are few reports in the ophthalmic literature regarding eye wounds as manifestation of self-injury. The incidence of self-enucleation, usually referred as oedipism 1 , 2 , is estimated at 1 in 30 million per year. 1 , 2 Ocular self-injury has been related to religious beliefs and guilt (as mentioned in the gospel of Matthew 5:29).…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of self-enucleation, usually referred as oedipism 1 , 2 , is estimated at 1 in 30 million per year. 1 , 2 Ocular self-injury has been related to religious beliefs and guilt (as mentioned in the gospel of Matthew 5:29). 2 , 3 Ocular self-injury may also occur during a psychotic episode, usually due to schizophrenia, and has also been reported in the context of substance abuse, mood disorders, and other organic diseases.…”

Section: Introductionmentioning

confidence: 99%

“… 2 , 3 Ocular self-injury may also occur during a psychotic episode, usually due to schizophrenia, and has also been reported in the context of substance abuse, mood disorders, and other organic diseases. 1 , 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

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Multiple Penetrating Eye Wounds Due to Suspected Self-Injury

Dalma-Weiszhausz¹,

Alvarado²,

Licona³

et al. 2021

tjo

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We present a case of a 29-year-old male night watchman complaining of sudden decreased vision, redness, and tearing of the left eye. On anamnesis, trauma was denied and personal past history was relevant for right eye enucleation due to an “eye injury” 8 years prior. At presentation, his visual acuity was 20/200 and intraocular pressure (IOP) was 10 mmHg. Slit lamp examination revealed a 1-mm inferonasal corneal wound and a localized lens opacity associated with extrusion and posterior extension of cortical material in the same quadrant. Echography confirmed posterior lens capsular bag puncture with hyperechogenic material in the anterior vitreous. Intraocular foreign body was ruled out. Topical anti-inflammatory and cycloplegic treatment was initiated with partial visual recovery, IOP rise, moderate anterior chamber inflammatory reaction, and an emergent posterior subcapsular cataract. A pars plana vitrectomy and lensectomy were performed. After surgery and recovery, best-corrected visual acuity with contact lens was 20/15. The patient was followed for 6 years, during which he returned 6 more times with a variety of new findings, such as new corneal leukoma, leaking corneal wounds, hypotony, choroidal folds, and choroidal detachments, each time with full visual acuity recovery. Some cases of ocular injury and self-mutilation have been described in the context of various psychiatric disorders. Self-inflicted injuries were suspected due to substance abuse, although the patient denied doing so. Referral to a psychiatrist was insisted on several occasions without success. However, potentially life-threatening complications may arise; therefore, psychiatric referral is imperative.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multiple Penetrating Eye Wounds Due to Suspected Self-Injury

Dalma-Weiszhausz¹,

Alvarado²,

Licona³

et al. 2021

tjo

View full text Add to dashboard Cite

show abstract

“…(2018) [11] 50s Male Right Cocaine Metallic object SAH; IVH in lateral, third and fourth ventricles; stroke secondary to vasospasm; cognitive impairment None Dilly and Imes (2001) [12] 54 Male Left Paranoid schizophrenia; recent discontinuation of medications…”

Section: Nonementioning

confidence: 99%

Subarachnoid hemorrhage and internal carotid artery dissection and occlusion following self-enucleation

et al. 2020

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Self-enucleation is an uncommon type of major self-injury, which may lead to severe neurological deficits and life-threatening complications, such as subarachnoid hemorrhage (SAH) and internal carotid artery (ICA) dissection and occlusion. Our patient is a 53-year-old man with a history of bipolar disorder and schizophrenia who presented with SAH, intraventricular hemorrhage, ICA dissection and occlusion, and right cerebral infarct following self-enucleation. Despite a Glasgow Coma Score of 6 on initial presentation, he improved with conservative management. He achieved a near-complete neurological recovery, with residual left lower extremity weakness and mild confusion. Self-enucleation is a major neurologic, ophthalmologic, and psychiatric emergency with a potential for serious neurological complications and contralateral visual loss. Yet, conservative management may lead to dramatic recovery.

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Fatal Oedipism: A Case Report and Literature Review

Gupta,

Houchens,

Khair

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To describe a unique case of a fatal self-enucleation and review previously published cases. Methods: The authors describe a unique case of a complete unilateral self-enucleation while under the influence of drugs, which resulted in severe intracranial hemorrhages, right internal carotid artery opacification, and death. A literature review was performed by searching articles published before January 2023 in the Pubmed/MEDLINE database using the keywords “auto-enucleation or self-enucleation.” Cases of self-inflicted damage to the globe without severing any connections were excluded. Results: A literature review identified a total of 54 articles and 75 patients who had self-enucleated at least one globe completely (84.0%). Their average age was 37 years and 50.7% were male. At the time of auto-enucleation, 64.0% of these patients had known psychiatric disorders, and 28.0% were found to be under the influence of illicit drugs or alcohol. Auto-enucleation resulted in intracranial complications in 26.7% of cases. There has been 1 prior case, which, like the authors’ case, resulted in death due to intracranial complications. However, this occurred in a patient who partially enucleated one eye after a self-inflicted injury to the fellow eye. The current case is unique as these complications resulted from a complete unilateral auto-enucleation. Conclusions: The severity of this case’s presentation and outcome highlights the importance of prompt neuroimaging and a thorough assessment. Prompt psychiatric assessment and treatment are also required.

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Ocular self-mutilation: a case series

Cited by 3 publications

References 13 publications

Multiple Penetrating Eye Wounds Due to Suspected Self-Injury

Multiple Penetrating Eye Wounds Due to Suspected Self-Injury

Subarachnoid hemorrhage and internal carotid artery dissection and occlusion following self-enucleation

Fatal Oedipism: A Case Report and Literature Review

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