@article{ref1,
title="Self-enucleation and severe ocular injury in the psychiatric setting",
journal="Psychosomatics",
year="2016",
author="Clinebell, Kimberly and Valpey, Robin and Walker, Teresa and Gopalan, Priya and Azzam, Pierre",
volume="57",
number="1",
pages="25-30",
abstract="BACKGROUND: Although the first medically-reported case of auto-enucleation was described in the mid-19th century, ocular self-gouging has long been depicted in historical legend and mythology. Cases of enucleation have since been identified across various cultures. Though relatively uncommon, this major form of self-mutilation now afflicts approximately 500 individuals per year, and may present more commonly among certain clinical populations. <br><br>METHODS: We present 2 cases of self-enucleation in patients with psychotic illnesses and review existing literature on the history of enucleation, associated pathology, and management (both medically and psychiatrically) for this serious form of self-injury. <br><br>RESULTS: Literature review includes a brief historical perspective of auto-enucleation and its context in psychosomatic medicine, with cases to highlight key aspects in the prevention and management of ocular self-injury. Normal eye pathology is described briefly, with a focus on medical care after self-inflicted damage, as pertinent to consultation psychiatrists. Interventions for behavioral and pharmacologic management of agitation and impulsivity are reviewed, including consideration for electroconvulsive therapy, in this particular context. <br><br>CONCLUSION: Although severe ocular self-injury is uncommon, psychiatrists should be familiar with approaches to prevent and manage auto-enucleation in individuals at risk thereof. Consultation psychiatrists must work closely with ophthalmologists to address affective, behavioral, and cognitive triggers and complications of ocular self-injury.<p /> <p>Language: en</p>",
language="en",
issn="0033-3182",
doi="10.1016/j.psym.2015.10.010",
url="http://dx.doi.org/10.1016/j.psym.2015.10.010"
}