Resolution of self-injurious behavior in a nonverbal and developmentally delayed patient after surgical treatment of a blind painful eye

Audrey C Ko; Kelly H Yom; Don O Kikkawa

doi:10.1016/j.ajoc.2019.03.011

Resolution of self-injurious behavior in a nonverbal and developmentally delayed patient after surgical treatment of a blind painful eye

Am J Ophthalmol Case Rep. 2019 Mar 30:14:110-111. doi: 10.1016/j.ajoc.2019.03.011. eCollection 2019 Jun.

Authors

Audrey C Ko¹, Kelly H Yom¹, Don O Kikkawa²

Affiliations

¹ Department of Ophthalmology and Visual Sciences, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
² Department of Ophthalmology, University of California, San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA.

Abstract

Changes in behavioral patterns can be the only indication of the presence of pain in nonverbal patients. Phthisis bulbi results in shrinking, disorganization, and sometimes severe inflammation of the ocular globe and can occur after eye injury or multiple eye surgeries. Chronic tearing, frequent eye rubbing, and self-injurious behavior focused around the eye and periocular region may indicate ocular discomfort in nonverbal patients. In eyes that become painful and refractory to medical treatment, ocular evisceration or enucleation can provide immediate pain relief. An ocular prosthesis provides excellent cosmetic results to restore normal facial appearance after surgery.

Keywords: Blind painful eye; Enucleation; Evisceration; Nonverbal; Phthisis bulbi; Self-injurious behavior.