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Ophthalmic Images
January 9, 2020

Self-inflicted Ocular Injury—Does It Relieve the Pain?

Author Affiliations
  • 1Department of Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
JAMA Ophthalmol. 2020;138(1):e190055. doi:10.1001/jamaophthalmol.2019.0055

A man in his 20s reported decreased vision in his left eye following kidnapping and ocular assault with a metallic pin. He had no perception of light in his left eye. Examination results showed a clear cornea, traumatic cataract, and a metallic pin protruding through inferior sclera (Figure, A). Radiography results confirmed the pin, which then was removed. He presented again several days later with a similar history. Palpation around the globe suggested multiple pins in the orbit. A computer tomography scan and volume-rendered multiplanar reconstructive images showed multiple pins in the orbit (Figure, B). Sixty-four pins were removed. A psychiatric evaluation revealed depression. He was inserting his father's used insulin needles into his eye. He had no known history of attempted suicide or mutilation of other parts of his body. Following multiple psychotherapy sessions, his depression improved.

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