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Severe Self-Mutilation of the Eye as a First Sign of Psychosis – a Case Report


Authors: D. Hejcmanová 1;  M. Hůlková 2;  L. Bytton 1;  D. H. Nikolov 3
Authors‘ workplace: Oční klinika FN, Hradec Králové, přednosta prof. MUDr. Pavel Rozsíval, CSc., FEBO 1;  Psychiatrická klinika FN, Hradec Králové, přednosta prof. MUDr. Jan Libiger, CSc. 2;  Fingerlandův ústav patologie, FN Hradec Králové, přednosta prof. MUDr. Aleš Ryška, CSc 3
Published in: Čes. a slov. Oftal., 65, 2009, No. 6, p. 244-247
Category: Case Report

Overview

Self-enucleation of the eyeball is severe and rare form of self-destruction in ophthalmology. The authors refer a 28 years old man, previously not treated on psychiatry, who enucleated his left eye with the fork himself. Examination of the enucleated eye revealed an absolutely intact eyeball with the 4.5 cm long optic nerve pulled out; a hemorrhage in the left orbit was found as well. The CT examination revealed orbital hematoma and pneumoorbit with the absence of the left eye and the optic nerve, without intracranial bleeding. Primary wounds of the eyelids and the conjunctiva were treated; the visual functions of the right eye were without damage. The patient was immediately hospitalized at the Psychiatric department where the diagnosis of paranoid schizophrenia was set. We point out the necessity of quick resuscitation of the patient, and furthermore near collaboration among the ophthalmologist, the psychiatrist, and the neurosurgeon to set further treatment procedure.

Key words:
self-enucleation of the eye, Oedipus complex, psychosis, self-mutilation


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