Self-inflicted eye injuries: case presentations and a literature review

Abstract

Objective: The authors' aim was to determine demographic and clinical correlates of self-inflicted eye injury.

Methods: The authors reviewed 41 cases of patients with self-inflicted eye injuries identified through MEDLARS searches of medical literature for the period from 1980 to 1993 and four cases from the first author's clinical practice.

Results: Most patients with self-inflicted eye injuries were male, about 31 years old, and had a diagnosis of schizophrenia, drug or alcohol abuse, depressive disorders, or other psychosis. Some patients experienced cognitive distortions, often involving religious and sexual ideation, and intense fear around the time they injured themselves. Thirty-three percent of the patients with self-inflicted eye injuries also showed other types of self-injurious behavior.

Conclusions: Enucleation of the eye may serve as a defense against witnessing or experiencing a forbidden act. Psychodynamic theories addressing self-mutilation do not explain self-induced eye injury particularly well but may assist the therapist in understanding motivation and in restructuring patients' behavior. Management of these patients requires multidisciplinary, multimodal efforts involving medical specialists, patients, family members, and staff.