A Case Report of Bilateral Autoenucleation and Its Prevention

Abstract

Purpose: To report a case and review both the ophthalmic and psychiatric literature to document the pattern of this self-mutilation and review prevention techniques. Design: Case report and retrospective review. Interventions: Surgical repair of the orbits in a patient who autoenucleated both eyes. Main Outcome Measures: To determine methods to prevent self-destructive behavior. Results: Up to 75% of these acts are performed by psychiatric inpatients as a form of focal suicide. Methods to prevent self-inflicting behavior include differential reinforcement, boxing gloves, soft cotton gloves, a bubble helmet, facial screening, electrical stimulation, and tarsorraphy. Conclusions: Prevention of autoenucleation requires early identification of susceptible subjects and timely initiation of preventive measures.