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#1
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07-25-2021, 01:49 AM
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 My Rank: PRIVATE FIRST CLASS Poster Rank:3868 Female Join Date: May 2020 Posts: 84 Mentioned: 0 Post(s) Quoted: 18 Post(s)
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Scissors in the Eye
An elderly woman with schizophrenia presented with a pair of scissors penetrating her left orbit and an enucleated right globe (Figure 1). Computed tomography (CT) revealed a pair of scissors penetrating the superior orbital fissure, with the blades traveling lateral to the left cavernous sinus and midbrain and ending just superior to the left cerebellar hemisphere (Figures 2 and 3). She underwent left pterional craniotomy and removal of the scissors, with insertion of an external ventricular drain. Exploration under anesthesia revealed no left globe rupture, but the globe had been severed from the ophthalmic artery and nerve. Diagnosis: Autoenucleation Autoenucleation is predominantly a manifestation of psychosis, especially if there are concurrent delusions that a patient’s eyes pose a threat to themselves or their loved ones. Initial emergency management includes CT to rule out subarachnoid hemorrhage. Antipsychotics should be considered, perhaps even in the absence of psychotic symptoms because of the near certainty of an underlying psychosis. Subsequent inpatient management includes one-to-one nursing, fingerless mittens, and arm restraints; these may be the only way to prevent deluded and determined patients from causing more damage as antipsychotic medications take effect. Prevention is key; mental health practitioners should be alert to delusions about eyes and consider regularly assessing a patient’s risk of self-mutilation. Further patient psychiatric history revealed poor compliance with medication, leading to intense hallucinations of her deceased son’s voice telling her that her eyes were “evil” and required removal. She died 5 months later after developing an intracranial abscess. Source: IMAGES IN EMERGENCY MEDICINE| VOLUME 67, ISSUE 6, E19-E20, JUNE 01, 2016  ·  ·  · |
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#2
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07-25-2021, 02:24 AM
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 ★ Legacy Member ★ Poster Rank:248 So many choices now Join Date: Jul 2015 Posts: 5,548 Mentioned: 15 Post(s) Quoted: 2120 Post(s)
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Re: Scissors in the Eye
Jeezus! She went handle-deep with that jab. For that, she gets a gold star and a smiley face on her weekly chart - posthumously, of course.  |
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#4
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07-25-2021, 02:30 AM
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| My Rank: PRIVATE FIRST CLASS Poster Rank:3868 Female Join Date: May 2020 Posts: 84 Mentioned: 0 Post(s) Quoted: 18 Post(s)
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Re: Scissors in the Eye
This is my first time ever finding anything worthy of gracing the forums and I couldn't be more proud of myself lol. Spent the afternoon reading about cases of fatal animal attacks which then lead to facial trauma recovery. Somehow stumbled on this and instantly knew I had to share. |
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#6
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07-26-2021, 02:04 AM
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 ♚ Legacy Gold Member ♚ Poster Rank:195 Female Join Date: Nov 2009 Posts: 7,761 Mentioned: 5 Post(s) Quoted: 708 Post(s)
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Re: Scissors in the Eye
That’s sad. Poor woman. Mental health should be taken more seriously.
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