Br J Ophthalmol doi:10.1136/bjophthalmol-2012-301531
  • Innovations

Self-enucleation: forget Freud and Oedipus, it's all about untreated psychosis

Press Release
  1. Olav B Nielssen2,3
  1. 1School of Psychiatry, University of New South Wales, Sydney, Australia
  2. 2Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, Australia
  3. 3Discipline of Psychological Medicine, University of Sydney, Sydney, Australia
  1. Correspondence to Dr Matthew Michael Large, Mental Health Services, The Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia; mmbl{at}
  1. Contributors ML conceived the paper and wrote the initial draft and approved the final draft. ON conceived the paper and wrote the initial draft and approved the final draft.

  • Accepted 18 January 2012
  • Published Online First 28 February 2012


Self-enucleation is a rare but serious ophthalmological and psychiatric emergency. It has traditionally been considered to be the result of psycho-sexual conflicts, including those arising from Freud's Oedipal complex and Christian religious teaching. However, an analysis of published case reports suggests that self-enucleation is a result of psychotic illnesses such as schizophrenia. Early treatment with antipsychotic medication in the case of unilateral or threatened self-enucleation might prevent some cases of blindness.


  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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