SEVERE OCULAR SELF-INJURY

To further delineate the clinical characteristics of patients who deli berately, severely mutilate their eyes, we reviewed the medical record s of a specialty eye hospital and found nine cases of intentional, sev ere, self-inflicted eye injuries. We identified two groups of patients . Most were young psychotic individuals with severe psychopathology of ten involving sexual and religious delusions, command hallucinations, and the propensity to act on delusions. The second group was comprised of patients with organic disabilities, either dementia or severe ment al retardation, where a lack of impulse control and preexisting eye ir ritation or surgical operation may have contributed to the act. One pa tient was a recidivist. Two-thirds of the patients were confined at th e time of the act. That self-mutilation may occur frequently in confin ed patients calls for active vigilance from caretakers; that it may re cur calls for caution by the psychiatrist.