Attempted autoenucleation: Was not a Greek tragedy!

Abstract

Autoenucleation, also known as oedipism, is one of the most horrifying forms of self-mutilation frequently reported in literature. This is a case report of a 28-year-old schizophrenic man who autoenucleated his right eye. On examination, globe was luxated, his conjunctiva was lacerated superiorly with Tenon's prolapse, and he had a subconjunctival hemorrhage. Ocular movements were restricted in all positions of gaze. The eye could not be pushed back under general anesthesia. A lateral canthotomy was performed and the lids were sutured along the gray line after forcibly pushing the eye into the orbit. The patient was given intravenous antibiotics and steroids. Antipsychotic medications were restarted. After 1 month, the patient again tried to self-enucleate and was brought to the hospital. The globe was in situ with almost normal ocular movements. This report emphasizes the need to salvage the eye, even in worst of the cases.

Keywords

• Enucleation
• lateral canthotomy
• lateral rectus
• medial rectus
• oedipism