A Case of Eyeball Perforation Through Self-injury Found in a Narcoleptic Patient

PURPOSE: Narcolepsy is a specific neurologic syndrome consisting of excessive daytime drowsiness, cataplexy, and the additional phenomena of sleep paralysis and intense dreamlike hallucinations at sleep-wake transitions. We are reporting a patient with narcolepsy whose repeated self-injury caused traumatic eyeball perforation. METHODS: A 26-year-old male with narcolepsy injured himself, which resulted in eyeball perforation in his both eyes. We diagnosed him as traumatic corneal laceration, traumatic cataract, and vitreous opacity due to lens material in vitreous in both eyes. RESULTS: After improvement of narcoleptic symptom and healing of corneal perforation, we performed cataract extraction and pars plana vitrectomy under local anesthesia. During operation, we found preretinal gliosis at superior portion of optic disc and subretinal hemorrhage in the right eye. We observed successful improvement in visual acuity through intraocular lens implantation.

A Statistical Analysis of Ocular Injuries of Inpatients

The authors analysed 127 patients(130 eyes) with ocular injuries among 561 inpatients who had been admitted to Chung-Ang University Hospital during the period of 3 years from January 1986 to December 1988. 1. The incidence of ocular injuries was 22.6% of all inpatients. 2. The incidence was more common in male(91.3%) and in the age of second(40.1%) and third decade(20.5%). 3. The most common cause of ocular injuries was industrial acddent(34.6%), followed by fight(22.0%) and traffic accident(18.9%). 4. The ocular injuries commonly developed between 11 and 14 o'clock(29.9%). Especially, 43.2% of the industrial ocular injuries occurred at this time. 5. The most common causative agent of ocular injuries was broken glass pieces(26.8%), followed by metal(18.9%) and fist and foot(17.3%). 6. The most common nature of ocular injuries was eyeball perforation(53.0%), followed by hyphema(18.5%). 7. The expectancy of a good visual outcome were nonperforating injury, corneal laceration and absence of severe prolapse of intraocular tissue. 8. The most common complication was corneal opacity(58.7%).