Self-inflicted Eye Injuries and Self-inflicted Blindness

Cm, Tapper; Rc, Bland; Danyluk, L.

doi:10.1097/00005053-197905000-00008

Cited by 40 publications

(25 citation statements)

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“…Other psychiatric conditions described in association with self-inflicted eye injuries include obsessivecompulsive disorder, 3,8,9 profound affective disorder (particularly psychotic depression), 11 post-traumatic stress disorder, 30 Munchausen syndrome, [31][32][33] and borderline personality disorder. 34 Organic states described in association with selfinflicting eye injuries include temporal lobe epilepsy, 35 encephalitis 36 neurosyphilis, 13 frontal lobe encephalomalacia, 14 and there has been one report in association with diabetes.…”

Section: Biochemical Theoriesmentioning

confidence: 99%

“…3,[48][49][50] However, they are of great importance, as failure to recognise the injury may be fatal. A penetrating object of greater than 5 cm in length may reach the cranial cavity via the superior orbital fissure, shearing vessels, and nerves as it travels.…”

Section: Orbital Injuriesmentioning

confidence: 99%

“…1 They have been associated with a variety of disorders, including paranoid schizophrenia, [2][3][4][5] druginduced psychosis, 3,6,7 obsessive-compulsive disorder, 3,8,9 depression, 3,10,11 mental retardation, 12 and ritualistic behaviour. 1 It has also been reported in patients with a variety of organic illnesses, including neurosyphilis, 13 Lesch-Nyhan syndrome, 12 and structural brain lesions.…”

Section: Introductionmentioning

confidence: 99%

“…14 It has been described in both adults and children, but occurs most commonly in young adults with acute or chronic psychoses. 3,15 Most of the literature features individual case reports. This review summarises the literature of deliberate selfinflicted eye injuries, including the pathogenesis, both psychiatric and biological, clinical characteristics, and management.…”

Section: Introductionmentioning

confidence: 99%

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Self-inflicted eye injuries: a review

Patton

2004

Eye

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Purpose To review the pathogenesis, clinical characteristics, and management of selfinflicted eye injuries. Methods Review of the medical literature. Results Psychiatric theories of pathogenesis for self-inflicted behaviour include religious and sexual ideation, symbolism, guilt, and displacement. Biological theories include disorders of serotonergic, dopaminergic, and opiate neurotransmitters. Clinical characteristics of self-mutilators include acute or chronic psychoses, drug-induced psychoses, other psychiatric conditions, and certain organic states. The majority are young-to-early middle-aged male subjects, though it can also rarely occur in children. Management of selfinflicted eye injury requires close cooperation between ophthalmologists and psychiatrists as well as other medical specialists, to ensure quick resuscitation of the patient, prompt diagnosis and treatment of any injuries, and treatment of the underlying behaviour that led to the injuries. Conclusions Self-inflicted eye injuries are a rare but important group of ophthalmic conditions that require close cooperation between different medical specialties to ensure optimum care of the often severely disturbed patient.

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Section: Biochemical Theoriesmentioning

confidence: 99%

Section: Orbital Injuriesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Self-inflicted eye injuries: a review

Patton

2004

Eye

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“…The few authors who have reviewed more than a small number of cases have attributed MSM to the direct effects of psychotic illness. [3][4][5][6][7] In a recent review of self-inflicted eye injures, we found that almost all cases of serious self-inflicted eye injuries result from schizophrenia spectrum psychosis and half the injuries that caused permanent loss of vision occurred in the first episode of psychosis (FEP). 7 Studies that have examined prior treatment at the time of another uncommon and catastrophic complication of psychosis, homicide, generally report that between 30% and 50% occur during the FEP, 8 usually in response to frightening symptoms.…”

Section: Introductionmentioning

confidence: 99%

Major Self-mutilation in the First Episode of Psychosis

Babidge

Andrews

Storey

et al. 2008

Schizophrenia Bulletin

122

128

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Major self-mutilation (MSM) is a rare but catastrophic complication of severe mental illness. Most people who inflict MSM have a psychotic disorder, usually a schizophrenia spectrum psychosis. It is not known when in the course of psychotic illness, MSM is most likely to occur. In this study, the proportion of patients in first episode of psychosis (FEP) was assessed using the results of a systematic review of published case reports. Histories of patients who had removed an eye or a testicle, severed their penis, or amputated a portion of a limb and were diagnosed with a schizophrenia spectrum psychosis were included. A psychotic illness was documented in 143 of 189 cases (75.6%) of MSM, of whom 119 of 143 (83.2%) were diagnosed with a schizophrenia spectrum psychosis. The treatment status of a schizophrenia spectrum psychosis could be ascertained in 101 of the case reports, of which 54 were in the FEP (53.5%, 95% confidence interval 43.7%-63.2%). Patients who inflict MSM in FEP exhibited similar symptoms to those who inflict MSM later in their illness. Acute psychosis, in particular first-episode schizophrenia, appears to be the major cause of MSM. Although MSM is extremely uncommon, earlier treatment of psychotic illness may reduce the incidence of MSM.

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