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Okafor L, Choudry A, Mudhar HS, et al. Oedipism: An unusual case of auto-enucleation including mechanism of avulsion. Eur J Ophthalmol. 2020;1120672120972028doi: 10.1177/1120672120972028.
Okafor, L., Choudry, A., Mudhar, H. S., & Sandramouli, S. (2020). Oedipism: An unusual case of auto-enucleation including mechanism of avulsion. European journal of ophthalmology, 1120672120972028. https://doi.org/10.1177/1120672120972028
Okafor, Linda, et al. "Oedipism: An unusual case of auto-enucleation including mechanism of avulsion." European journal of ophthalmology vol. (2020): 1120672120972028. doi: https://doi.org/10.1177/1120672120972028
Okafor L, Choudry A, Mudhar HS, Sandramouli S. Oedipism: An unusual case of auto-enucleation including mechanism of avulsion. Eur J Ophthalmol. 2020 Nov 13;1120672120972028. doi: 10.1177/1120672120972028. Epub 2020 Nov 13. PMID: 33183093.
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Eur J Ophthalmol. 2020 Nov 13;1120672120972028. doi: 10.1177/1120672120972028. Epub 2020 Nov 13.

Oedipism: An unusual case of auto-enucleation including mechanism of avulsion.

European journal of ophthalmology

Linda Okafor, Abid Choudry, Hardeep S Mudhar, Soupramanien Sandramouli

Affiliations

  1. Department of Ophthalmology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  2. Department of Psychiatry, Black Country Healthcare Foundation Trust, Penn Hospital, Wolverhampton, UK.
  3. National Specialist Ophthalmic Pathology Service, Department of Histopathology, Royal Hallamshire Hospital Sheffield, Sheffield, UK.

PMID: 33183093 DOI: 10.1177/1120672120972028

Abstract

INTRODUCTION: Self-inflicted enucleation, also known as auto-enucleation (AE) or Oedipism, is an uncommon and severe form of ocular injury which presents as an ophthalmic and psychiatric emergency. Usually known to occur with untreated psychosis, this case is a rare report which demonstrates AE as a result of a subsequently diagnosed drug induced psychosis. We report the clinical presentation, management and for the first time a detailed speculative account about the mechanism of AE, based on our clinicopathologic findings.

CASE REPORT: A 53-year old Afro-Caribbean patient was arrested following an altercation and was incarcerated awaiting arraignment. The patient had no previous psychiatric history but tested positive for cannabis, opiates and cocaine as well as admitting to illicit drug use in the community. Whilst in custody, the patient self-enucleated his right eye. The patient declined consent to eye examination and was subsequently admitted under section 2 of the Mental Health Act. After full work-up including Goldmann visual fields and magnetic resonance imaging, he underwent right orbital exploration under anesthetic where AE was confirmed whilst the left eye showed evidence of attempted enucleation. The residual tenons and conjunctiva was subsequently repaired without placement of an orbital implant in the right orbit. The globe was sent for histology which revealed clues to the potential mechanism of auto-enucleation.

CONCLUSION: This case is unique as it offers an alternative presentation to those most commonly reported in the current literature, highlights the sparsity of literature detailing the mechanism of AE and stimulates discussion around various potential systemic etiological differential diagnoses, management strategies and complications of AE.

Keywords: Oedipism; auto-enucleation

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