@article{ref1,
title="Ocular nonsuicidal self-injury in a teenager",
journal="Oman journal of ophthalmology",
year="2018",
author="Comacchio, Francesco and Ricca, M. and Martini, G. and Cecchin, V. and Zannin, Maria Elisabetta",
volume="11",
number="1",
pages="55-57",
abstract="A 14-year-old male teen presented with unilateral episcleritis, unresponsive to topical and systemic corticosteroid therapy, without a history of ocular trauma or evidence for systemic diseases. The presence of foreign bodies in the conjunctival mucus of the hyperemic fornix has been noticed during one of the follow-up examinations. The toxicological analysis of conjunctival mucus revealed the presence of ethylene glycolmonomethyl ether and triethilene glicolebuthyl ether, used as solvents in nail polish removers and all-purpose cleaners. An unexpected etiology of chemical self-inflicted episcleritis was determined. The teen was admitted to a psychological assessment, after which a psychotherapeutic treatment was recommended. Episcleritis is characterized by the acute onset of ocular pain and redness, with a frequent recurrent and stressful course. Since it can be associated with life-threatening systemic vasculitides, a prompt, aggressive immunosuppressive therapy may be considered, both for the ocular inflammation and for the underlying systemic condition. Rarely episcleritis does not improve despite topical and systemic therapy, administered in a stepladder way. The reported teenager case needed a complex multidisciplinary approach to achieve the correct diagnosis and to avoid unnecessary treatments. In the case of recognized &quot;nonsuicidal self-injury,&quot; a psychological evaluation is strongly recommended, to identify and address underlying neuropsychiatric problems.<p /> <p>Language: en</p>",
language="en",
issn="0974-620X",
doi="10.4103/ojo.OJO_209_2016",
url="http://dx.doi.org/10.4103/ojo.OJO_209_2016"
}