Self-Inflicted Bilateral Ocular Surface Injury: Two Case Reports

Aim: To present two cases of self-inflicted ocular surface injury.Case report: First case was a 13-year-old girl with reduction of vision in both her eyes (? counting finger) and redness with conjunctival laceration in the temporal area, surprisingly, without any pain for one month. The patient denied any history of trauma and lives in a girls hostel at that school. On examination, subjective visual acuity was in both eyes (?) counting finger one foot, brisk pupillary reaction, quiet anterior chamber, clear lens  with normal fundi of both eyes. Most probably self- induced conjunctival injuries, she used her finger-nail  for this purpose and looks accessible part of the ocular surface. The second case was a 55-year-old woman presented with a foreign body sensation, watering, redness and blurring of vision in both eyes for two weeks. The patient denied any history of trauma, subjective visual acuity was 6/36 in both eyes, congested conjunctiva, brisk pupillary reaction, quiet anterior chamber, senile early cataractous lens with normal fundi of both eyes. Fluorescein stain showed 3x4 mm epithelial defect over the lower part of both corneas. She was using a paper napkin to sweep her eyes for removal of foreign bodies frequently and injured by herself. They were given treatment with broad spectrum topical antibiotic eye drops, weak corticosteroid and artificial tear substitute and strong counseling. The lesions healed within 2 weeks.Conclusion: Self-inflicted ocular injuries are very rare, and usually need immediate medical treatment, strong counseling and psychiatrist consultations.

Keywords:- Self-Inflicted Injury, Ocular Surface, Functional Disorders, Organic Disorders, Strong Counseling.