Self-inflicted eye injuries: a review

Abstract

Purpose To review the pathogenesis, clinical characteristics, and management of selfinflicted eye injuries. Methods Review of the medical literature. Results Psychiatric theories of pathogenesis for self-inflicted behaviour include religious and sexual ideation, symbolism, guilt, and displacement. Biological theories include disorders of serotonergic, dopaminergic, and opiate neurotransmitters. Clinical characteristics of self-mutilators include acute or chronic psychoses, drug-induced psychoses, other psychiatric conditions, and certain organic states. The majority are young-to-early middle-aged male subjects, though it can also rarely occur in children. Management of selfinflicted eye injury requires close cooperation between ophthalmologists and psychiatrists as well as other medical specialists, to ensure quick resuscitation of the patient, prompt diagnosis and treatment of any injuries, and treatment of the underlying behaviour that led to the injuries. Conclusions Self-inflicted eye injuries are a rare but important group of ophthalmic conditions that require close cooperation between different medical specialties to ensure optimum care of the often severely disturbed patient.

Autoenucleation in a 84-year-old dementia patient

“…Most publications on this topic point out its religious background, based on the bible verses of Matthew 5:29, and thereby explain the accumulation of cases in Western countries [2]. Other theories suggest sexual ideations and even biochemical theories, such as alterations in serotonin metabolism [3].…”

Bilateral Acute Endophthalmitis Associated With Munchausen Syndrome

“…5 At the psychological level, the eye may represent conflict and/or guilt, and mutilation may provide temporary relief from these emotions. 2 At the biochemical level, abnormalities in the serotonin system, dopaminergic, and opiate systems have been associated with selfmutilating behavior in several genetic disorders. 2 Self-inflicted ocular injuries range from enucleation 6 by fingers, razors, 7 pencils, and knives 2 to chemical injuries.…”

“…Self-inflicted ocular injury is well documented in the literature. 2 Typically, self-inflicted ocular injury occurs in young to middle-aged males 3 and in patients with psychiatric disorders such as obsessive compulsive disorders, 2 posttraumatic stress disorder, 4 and Munchausen syndrome. 5 At the psychological level, the eye may represent conflict and/or guilt, and mutilation may provide temporary relief from these emotions.…”

Eroin bağımlısı bir erkek hastada tedaviyi engelleyen çoklu kendine zarar verme davranışı: Olgu sunumu / Heroin dependent male patient with multiple types of self mutilative behaviors that impair the treatment: a case report

“…Gözü kaşıma, göze vurma, yabancı maddeler enjekte etmekten oto-enükleasyona kadar değişen şekillerde yaralanmalar görülebilir (27). Paranoid şizof-renide (28), maddeye bağlı psikozda (29), depresyonda (30), obsesif kompulsif bozuklukta (31), yapay bozuklukta (32), ayrıca Lesch-Nyan sendromunda (33) görül-düğü belirtilmiştir.…”

“…Patton (27), korneal abrazyona yol açmak için tırnak ya da parmaklarla yapılan mekanik travmanın yapay bozuklukta görülebileceğini bildirmiştir. Ancak, sunduğumuz olgunun yapay bozukluğu düşündürecek birincil kazancı, bir medikal başvurusu ya da medikal öykü-sü yoktu.…”