Case 11-1: Autoenucleation
A young patient presented with alcoholic hallucinosis. The patient had reportedly autoenucleated his eye.
The patient had an obvious enucleation of his eye.
Altered mental status secondary to toxicologic exposure
Central nervous system disorder
Metabolic or endocrine disorder
The patient had no other injuries and was admitted to the hospital for further management of his self-enucleation and alcoholic hallucinosis.
This patient was lost to follow-up.
Alcohol hallucinosis develops 12 to 24 hours after the last alcohol ingestion, generally lasts 1 to 2 days, and the hallucinations are most often visual, although auditory and tactile hallucinations can also occur.
Alcohol hallucinosis is not related to delirium tremens.
Patients maintain a clear sensorium, and thus they are aware they are experiencing hallucinations.
Autoenucleation is most common in the context of significant psychiatric disease.
AH. Autoenucleation: a case report and literature review. Psychiatry (Edgmont)
J. Enucleation as a form of self-aggression—2 case reports and review of the literature [in German]. Klinische Monatsblatter Fur Augenheilkunde
RK. Drug induced autoenucleation with resultant chiasmal damage. Br J Ophthalmol
TB. Self-inflicted eye injuries: case presentations and a literature review. Hosp Community Psychiatry
A. A case of autoenucleation associated with a contralateral field defect. Orbit
et al. Gender and racial disparities in cases of autoenucleation. Semin Ophthalmol
Case 11-2: High-pressure injection of air into the orbit
A 3-year-old child accidentally injected her orbit with a high-pressure air hose.
Left periorbital swelling with palpable subcutaneous emphysema
Noncontrast head CT scan (bone windows). WA = orbital air, WDA = pneumocephaly
The patient had a markedly swollen left periorbital area. Subcutaneous emphysema could be palpated.