Self-enucleation of the right eye by a 38-year-old woman diagnosed with schizoaffective disorder: a case report

Abstract

Background Autoenucleation is a rare form of self-mutilation typically associated with psychiatric disorders such as schizophrenia, substance-induced psychosis and bipolar disorder. The act is usually unilateral, although bilateral attempts are also well documented in the literature. Case presentation It is a case study involving a female patient (NN) diagnosed with schizoaffective disorder who self-enucleated her right eye following sexual intercourse with a fellow patient, and was forcefully prevented by staff from enucleating the second eye. We report recurrent episodes of her illness culminating in this severe act of self-mutilation. The motivational reasons behind this form of self-harm along with differential diagnosis and potential treatment options are discussed in the context of the available literature. Conclusion Autoenucleation is commonly associated with religious and sexual delusions, and patients are thought to be at a greater risk of further self-harm. Timely antipsychotic treatment is likely to reduce the risk of such extreme forms of self-harm, although they can occur despite robust therapeutic intervention and treatment attempts. While self-inflicted eye injuries are rare, their prevention in what is typically a difficult patient group is fraught with challenges.

Fatal Oedipism: A Case Report and Literature Review

“…Our review of the literature included 54 articles and 75 patients who self-enucleated at least one eye. 1,3–55 The features of these patients are described in Table 1. The patients had an average age of 37 years (±14 SD) and were 50.7% male.…”

Bilateral Self-Enucleation in the First Psychosis Episode in a Person With Deprived of Liberty: Case Report

“…4 Additionally, it is extremely rare to have bilateral selfenucleation and normally requires a high level of hallucinations. 7,8 Other authors also considered these events the results of psychosexual conflicts like Freud's Oedipal Complex. 9,10 Considering that, psychosis must be suspected in cases of selfharm when the self-inflicted injuries are highly harmful with no lethal intention, entail cultural or religious symbolic content, or lack any instrumentalization content.…”

Oedipism and Self-Amputation in a Schizoaffective, Depressed Type Patient: To Heal or Feel Pain?

“…Oedipism was formerly understood to be linked to hypersexuality and mythological and/or hyper-religious delusions [ 6 ]. However, based on more recently reported cases, the intent leading up to this act varies, although it is frequently linked to psychotic illnesses [ 9 ]. Self-injurious behavior is commonly known to occur in untreated psychosis, predominantly schizophrenia, or as the result of substance use-induced intoxication, such as alcohol, cannabis, hallucinogens like lysergic acid diethylamide and phencyclidine, and stimulants including amphetamine and cocaine [ 3 ].…”