A case report of bilateral autoenucleation and its prevention.

Purpose: To report a case and review both the ophthalmic and psychiatric literature to document the pattern of this self-mutilation and review prevention techniques.

Design: Case report and retrospective review.

Interventions: Surgical repair of the orbits in a patient who autoenucleated both eyes.

Main Outcome Measures: To determine methods to prevent self-destructive behavior.

Results: Up to 75% of these acts are performed by psychiatric inpatients as a form of focal suicide. Methods to prevent self-inflicting behavior include differential reinforcement, boxing gloves, soft cotton gloves, a bubble helmet, facial screening, electrical stimulation, and tarsorraphy.

Conclusions: Prevention of autoenucleation requires early identification of susceptible subjects and timely initiation of preventive measures.