Ocular self-mutilation

A 32-year-old paranoid schizophrenic man repeatedly stabbed both his eyes with a sharpened wire coat hanger. The patient underwent vitrectomy on each eye approximately 2 1/2 weeks after injury, with multiple retinal defects noted OU. None of the posterior wounds involved the macula or optic disc, and final vision was 20/70 OD and 20/50 OS. Ocular self-mutilation, deliberate and severe self-injury which threatens visual function, is a rare occurrence most often described in acutely psychotic patients. Psychosis may be due to schizophrenia, drug abuse, manic phases of bipolar mood disorders, and depression. A striking number of these patients have delusions with religious and sexual content. They are prone to repeated attempts during the acute psychotic phase and must be monitored closely at this time.