Four cases of self-enucleation are reported. Self-induced ocular mutilation is uncommon. Self-enucleation is rare and is specifically associated with paranoid delusions, either as a result of a drug-related toxic psychosis or in the functional psychoses, especially schizophrenia. An association with solvent abuse is reported. Such patients use self enucleation as a form of parasuicide and may mutilate themselves in other ways. In the management of such patients close co-operation between ophthalmologist and psychiatrist is important, as further self injury, including suicide is common.