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2018 ; 11
(1
): 55-57
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Ocular nonsuicidal self-injury in a teenager
#MMPMID29563698
Comacchio F
; Ricca M
; Martini G
; Cecchin V
; Zannin ME
Oman J Ophthalmol
2018[Jan]; 11
(1
): 55-57
PMID29563698
show ga
A 14-year-old male teen presented with unilateral episcleritis, unresponsive to
topical and systemic corticosteroid therapy, without a history of ocular trauma
or evidence for systemic diseases. The presence of foreign bodies in the
conjunctival mucus of the hyperemic fornix has been noticed during one of the
follow-up examinations. The toxicological analysis of conjunctival mucus revealed
the presence of ethylene glycolmonomethyl ether and triethilene glicolebuthyl
ether, used as solvents in nail polish removers and all-purpose cleaners. An
unexpected etiology of chemical self-inflicted episcleritis was determined. The
teen was admitted to a psychological assessment, after which a psychotherapeutic
treatment was recommended. Episcleritis is characterized by the acute onset of
ocular pain and redness, with a frequent recurrent and stressful course. Since it
can be associated with life-threatening systemic vasculitides, a prompt,
aggressive immunosuppressive therapy may be considered, both for the ocular
inflammation and for the underlying systemic condition. Rarely episcleritis does
not improve despite topical and systemic therapy, administered in a stepladder
way. The reported teenager case needed a complex multidisciplinary approach to
achieve the correct diagnosis and to avoid unnecessary treatments. In the case of
recognized "nonsuicidal self-injury," a psychological evaluation is strongly
recommended, to identify and address underlying neuropsychiatric problems.
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