Complications and outcomes after autoenucleation

Abstract

Purpose of review: Autoenucleation has long been described in the literature, dating back as far as the 4th century AD. Within a 3-month period, two patients were admitted to our hospital after autoenucleation. A comprehensive review of the literature was performed to identify trends in, risk factors for, and potential life-threatening complications of autoenucleation.

Recent findings: Two adult Caucasian men were transferred from outside hospitals after autoenucleation. One patient's urine tested positive for methamphetamines, and the second patient had a history of schizophrenia. In both cases, imaging of the head and orbits was performed to rule out secondary sequelae after self-enucleation. Patient one did not have any intracranial abnormalities. Patient 2 had a head computed tomography scan that showed a left internal carotid artery dissection, subarachnoid hemorrhage, and basal ganglia/thalamic stroke. Review of the literature revealed that almost all cases were associated with underlying mental illness and/or a history of drug abuse.

Summary: Autoenucleation occurs more frequently in patients with psychiatric illness or drug abuse. It can be a devastating injury, not only locally, but neurologically. Ophthalmologists should be aware of the potentially life-threatening consequences of autoenucleation.