Bilateral auto-enucleation: A case report

Abstract

Objectives: To present a case of bilateral auto-enucleation in a 75-year-old male Nigerian - a rare occurrence in the elderly. Method: Report of a male patient that plucked out his 2 eyes. Result: A 75-year-old man presented at Guinness Eye Centre Onitsha, having plucked out his 2 eyes a day earlier. His wife reported that he was behaving abnormally who had recently; when she came to bring breakfast she saw her husband’s 2 eyes on the floor and bleeding from the 2 eyes. Both patient and their wife were living alone and no one came to their house that morning. The patient said he gouged out his eyes in obedience to a voice urging him to do soothed a couple who recently lost their only male child. Examination showed a fully conscious, calm elderly man with normal vital signs, bilateral lid, periorbital oedema, chemosis, and disorganised orbits with the absence of eyeballs. His wife brought a polythene bag containing neatly wrapped two intact eyeballs, each with about 5cm of the attached optic nerve. Conclusion: Although auto-enucleation is not common among ophthalmic patients in Nigerians, this report should alert medical practitioners of this devastating ophthalmic consequence of neglected psychiatric disorders in the elderly.