An unusual case of self-inflicted penetrating needle injury to both eyes

Abstract

To describe an unusual case of non-accidental, penetrating needle injury to both eyes. Case report. The patient was a 12-year-old girl with no medical or psychiatric problems detected during regular school health screenings. She presented with sudden bilateral eye pain with severe visual loss, but denied any prior trauma. She was was found to have central, penetrating corneal wounds in both eyes, which extended to the fovea in the left eye. The penetrating needle track involved the mid-cornea to the fovea, suggesting that the patient had intentionally aimed the needle into the eye while directly focusing on the needle. She subsequently underwent bilateral cataract operations; and an associated tractional retinal detachment in the left eye remained stable. Postoperatively, her visual acuity improved from perception of light to 6/9 in the right; 6/30 in the left eye. Psychological evaluations and clinical assessments did not suggest any evidence of child abuse or sexual assault. It is thus highly possible that these needle injuries could be self-inflicted. This is an unusual case of self-inflicted needle injury to the eyes in a pediatric patient.