Oedipism: psychosis-induced self-enucleation

Abstract

Background: We report a case of complete unilateral self-enucleation in a schizophrenic patient.

Case presentation: A young male who defaulted schizophrenia treatment presented to the emergency department after self-enucleation of his right eye. He was brought in by his father, together with the intact enucleated globe packed in ice. On examination, he was agitated. The right eye socket showed periorbital oedema, ecchymosis, and no active bleeding. Horizontal laceration wounds were found over both canthi. Extraocular muscles were well-attached to the globe except for the superior and inferior oblique muscles. Serum and urine toxicology reports were negative. Computed tomography found no evidence of intracranial haemorrhage. He was treated as schizophrenia in acute psychosis.

Conclusion: Self-enucleation is a rare and serious act of self-mutilation as a result of untreated psychosis. It requires comprehensive care and multidisciplinary management to prevent further self-injury.