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Journal Article

Citation

Gupta L, Houchens T, Khair D, Hughes S, Vora P, Zoerner D, Fraser J, Timoney PJ. Ophthal. Plast. Reconstr. Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Society of Ophthalmic Plastic and Reconstructive Surgery, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/IOP.0000000000002537

PMID

38133607

Abstract

PURPOSE: To describe a unique case of a fatal self-enucleation and review previously published cases.

METHODS: The authors describe a unique case of a complete unilateral self-enucleation while under the influence of drugs, which resulted in severe intracranial hemorrhages, right internal carotid artery opacification, and death. A literature review was performed by searching articles published before January 2023 in the Pubmed/MEDLINE database using the keywords "auto-enucleation or self-enucleation." Cases of self-inflicted damage to the globe without severing any connections were excluded.

RESULTS: A literature review identified a total of 54 articles and 75 patients who had self-enucleated at least one globe completely (84.0%). Their average age was 37 years and 50.7% were male. At the time of auto-enucleation, 64.0% of these patients had known psychiatric disorders, and 28.0% were found to be under the influence of illicit drugs or alcohol. Auto-enucleation resulted in intracranial complications in 26.7% of cases. There has been 1 prior case, which, like the authors' case, resulted in death due to intracranial complications. However, this occurred in a patient who partially enucleated one eye after a self-inflicted injury to the fellow eye. The current case is unique as these complications resulted from a complete unilateral auto-enucleation.

CONCLUSIONS: The severity of this case's presentation and outcome highlights the importance of prompt neuroimaging and a thorough assessment. Prompt psychiatric assessment and treatment are also required.


Language: en

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