Self-inflicted Eye Injuries Research Articles

Self-inflicted eye injuries

Self-inflicted enucleation, also known as Auto-Enucleation (AE) or Oedipism, is an uncommon and severe form of ocular injury which presents as an ophthalmic and psychiatric emergency. Usually known to occur with untreated psychosis, our recent case report demonstrated AE as a result of a subsequently diagnosed drug induced psychosis. We reported the clinical presentation, management and for the first time a detailed speculative account about the mechanism of AE, based on our clinicopathologic findings. Below we summarise the important aspects of the case as well as reflect on the psychodynamic theories that exist to explain it.

Self-enucleation of the right eye by a 38-year-old woman diagnosed with schizoaffective disorder: a case report

BackgroundAutoenucleation is a rare form of self-mutilation typically associated with psychiatric disorders such as schizophrenia, substance-induced psychosis and bipolar disorder. The act is usually unilateral, although bilateral attempts are also well documented in the literature.Case presentationIt is a case study involving a female patient (NN) diagnosed with schizoaffective disorder who self-enucleated her right eye following sexual intercourse with a fellow patient, and was forcefully prevented by staff from enucleating the second eye. We report recurrent episodes of her illness culminating in this severe act of self-mutilation. The motivational reasons behind this form of self-harm along with differential diagnosis and potential treatment options are discussed in the context of the available literature.ConclusionAutoenucleation is commonly associated with religious and sexual delusions, and patients are thought to be at a greater risk of further self-harm. Timely antipsychotic treatment is likely to reduce the risk of such extreme forms of self-harm, although they can occur despite robust therapeutic intervention and treatment attempts. While self-inflicted eye injuries are rare, their prevention in what is typically a difficult patient group is fraught with challenges.

Cervical Myelopathy as a Complication of Untreated Motor Tics: A Cautionary Tale

AbstractTic disorders are common, affecting approximately 0.5 to 1% of children and adolescents. Treatment is required only when symptoms are bothersome or impairing to the patient, so many do not require intervention. However, on occasion tics may cause significant morbidity and are referred to as “malignant.” These malignant tics have resulted in cervical myelopathy, subdural hematoma secondary to head banging, biting of lips leading to infection of oral muscles, self-inflicted eye injuries leading to blindness, skeletal fractures, compressive neuropathies, and vertebral artery dissection. We describe a case of malignant tic disorder, with accompanying video segment, resulting in cervical myelopathy and quadriparesis in a child. We also discuss aggressive management strategies for neurologists to prevent potential lifelong disability. This case emphasizes that these malignant tics must be treated with all due haste to prevent such complications.

Outcomes after Retinal Detachment Resulting from Self-Inflicted Injury

To evaluate the clinical findings of 11 eyes of 7 patients who sustained retinal detachment (RD) caused by self-inflicted injury and to investigate the causes and the prognosis. Case series. Seven patients (11 eyes) with self-inflicted eye injuries leading to RD. Retrospective chart review of clinical history, mechanism of injury, and surgical outcomes. Clinical outcome after treatment for RD. Self-inflicted injury occurs more frequently in nonverbal patients with severe developmental delay. Retinal detachment repair has a poor prognosis, with frequent recurrences resulting from repeat self-injury and proliferative vitreoretinopathy. The degree of vision loss in these patients was difficult to assess because of the challenges in assessing visual acuity, but it was likely severe in most cases. Retinal detachment caused by self-inflicted injury frequently leads to a poor outcome because of recurrent RD. Closer monitoring of patients at greatest risk for ocular self-injury could help to prevent vision loss.

Self-inflicted eye injury

Self-injurious behavior (nonsuicidal self-injury, NNSI) is acommon phenomenon and occurs in Germany, especially in adolescence, with alifetime prevalence of 25-35%. In adulthood autoaggressive behavior is usually associated with mental illness, such as borderline personality disorder, as in the presented case. Eye injuries are rare. The treating physician is faced with the difficulty of correctly classifying the injury and clarifying suicidal intentions. Patient care requires alot of patience, empathy and time and has to include psychosocial aspects.

An unusual case of self-inflicted multiple needles injuries to eye

Self-inflicted eye injuries among psychiatric patients are rare but important group of ophthalmic conditions that require close cooperation between different medical specialties to ensure optimum care of the severely disturbed patient. They have been associated with a variety of disorders, including paranoid schizophrenia, drug-induced psychosis, obsessive-compulsive disorder, depression, mental retardation, and ritualistic behavior. It has been described in both adults and children, but occurs most commonly in young adults with acute or chronic psychoses.

Bilateral self-enucleation in acute transient psychotic disorder: the influence of sociocultural factors on psychopathology

Self-inflicted eye injuries are rare but a devastating consequence of a serious mental disorder. Bilateral self-enucleation also known as oedipism has been documented in ancient texts and myths. Various biologic, psychologic, and social theories have been put forward to explain this rare phenomenon. In this report, we describe a case of oedipism, which highlights the influence of sociocultural factors on the psychopathology in acute transient psychotic disorder.

Loss of vision secondary to obsessive–compulsive disorder: a case report

Objective To report a rare case of self-inflicted eye injury secondary to obsessive-compulsive disorder (OCD). Method Case report. Results A 41 year-old patient had significant bilateral visual loss and blunt trauma through touching his ocular cavities due to recurrent doubts regarding their shape and urges to check the format of bones and cartilages. Differential diagnosis with tic disorders is discussed, and the patient's treatment approach is described. Conclusion Although rare, severe clinical complications can occur in OCD.

Self-Inflicted Eye Injuries in First-Episode and Previously Treated Psychosis

The purpose of the present paper was to describe the circumstances and phenomenology of patients who remove or pierce their eyes or orbits during psychotic illness. In particular, the aim was to determine if patients in their first-episode psychosis (FEP) carry an increased risk of self-inflicted eye injury when compared to patients with previously treated psychosis (PTP). Data were extracted from all of the case reports published in English since 1960 and from two unpublished Australian cases. More than half of the cases of self-inflicted eye injury that resulted in permanent loss of vision occurred during FEP. Serious self-inflicted eye injuries are rare, but the risk appears to be greatest during FEP. Earlier treatment of emerging psychosis and close attention to patients who attempt to injure their eyes may occasionally prevent blindness.

Self-inflicted eye injuries: a review.

To review the pathogenesis, clinical characteristics, and management of self-inflicted eye injuries. Review of the medical literature. 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 self-inflicted 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. 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.

Bilateral autoenucleation in a man with a severe personality disorder

AbstractA case of self-inflicted eye injury is described in a setting of alcohol intoxication and severe personality disturbance. The case is believed to be the only one of its type described this century. The relevant classical and contemporary literature is reviewed and psychopathological explanations discussed. Possible indicators of impending self-violence are reviewed.

Delusions of ocular parasitosis

Purpose: To describe four cases of delusions of parasitosis in which self-inflicted ocular trauma occurred. Delusions of parasitosis is a somatic delusional disorder in which patients have the irrational belief that their bodies are infested by parasites or other infectious organisms. Self-inflicted trauma can result from attempts to eliminate the supposed infestation. Methods: We reviewed the case histories of four patients (one male, three females, 35 to 45 years of age) who presented with complaints of ocular infestation but had no evidence of infectious ocular disease. The characteristics of these cases were compared with the features of delusions of parasitosis. Results: All patients maintained their beliefs regarding infestation, despite extensive clinical and laboratory investigations that found no evidence of infectious diseases. Self-inflicted eye injury, associated with attempts to eliminate the infestation, occurred in each case. Conclusions: The cases presented in this report are consistent with a diagnosis of delusions of parasitosis. The eye can be a principal focus of attention in this disorder, which may lead to vision loss caused by self-inflicted injury.

Severe ocular self-injury

To further delineate the clinical characteristies of patients who deliberately, severely mutilate their eyes, we reviewed the medical records of a specialty eye hospital and found nine cases of intentional, severe, self-inflicted eye injuries. We identified two groups of patients. Most were young psychotic individuals with severe psychopathology often involving sexual and religous delusions, command hallucinations, and the propensity to act on delusions. The second group was comprised of patients with organic disabilities, either dementia or severe mental retardation, where a lack of impulse control and preexisting eye irritation or surgical operation may have contributed to the act. One patient was a recidivist. Two-thrids of the patients were confined at the time of the act. That selfmutilation may occur frequently in confined patients calls for active vigilance from caretakers; that it may recur calls for caution by the psychiatrist.

Self-inflicted eye injuries.

Five cases of self-inflicted eye injury are described and discussed. A review of the literature shows that several psychiatric diagnoses have been assigned to people who damage their eyes. A variety of mechanisms to explain this phenomenon are described.

Self-inflicted Eye Injuries and Self-inflicted Blindness

The case of a young man, suffering from schizophrenia, who injured his eyes with his hands and blinded himself, is described, along with his rehabilitation program. The classical and contemporary literature on self-inflicted blindness and self-inflicted eye injuries is reviewed and shows a wide range or psychiatric diagnoses and illustrates the inadequacy of attempting to apply oversimplified psychodynamic explanations. In contrast, the reaction to blindness appears to be relatively uniform, leading to the possibility of using established rehabilitation programs.

Self-Inflicted Eye Injuries

Self-Inflicted Eye Injuries