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This study details a fatal case of self-enucleation due to drug influence and reviews 75 similar cases. Complete self-enucleation can lead to severe intracranial complications and death.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Psychiatry

Background:

  • Self-enucleation, the act of removing one's own eyeball, is a rare and severe form of self-inflicted injury.
  • It is often associated with psychiatric disorders and substance abuse.
  • Intracranial complications following self-enucleation can be life-threatening.

Purpose of the Study:

  • To describe a unique fatal case of complete unilateral self-enucleation.
  • To review previously published cases of self-enucleation to understand its incidence, characteristics, and outcomes.

Main Methods:

  • A comprehensive literature search was conducted on PubMed/MEDLINE for articles published before January 2023 using terms like "auto-enucleation" and "self-enucleation."
  • Cases involving self-inflicted damage without complete globe removal were excluded.
  • A unique case of drug-induced complete unilateral self-enucleation with fatal intracranial complications was described.

Main Results:

  • The literature review identified 75 patients who had completely self-enucleated at least one globe.
  • The average age of affected individuals was 37 years, with 50.7% being male.
  • Psychiatric disorders were present in 64.0% of cases, and 28.0% were under the influence of drugs or alcohol at the time of the event.
  • Intracranial complications occurred in 26.7% of cases, with one prior reported death from such complications.

Conclusions:

  • The presented case is unique due to fatal intracranial complications arising from complete unilateral self-enucleation.
  • This highlights the critical need for prompt neuroimaging and thorough patient assessment.
  • Urgent psychiatric evaluation and intervention are essential for managing patients with self-enucleation.