自傷行為により眼球脱臼を呈した統合失調症の1例

Self-inflicted luxation of the eyeglobe by a schizophrenic patient

　32歳女性が1年前に統合失調症と診断され，内服加療中であった。自宅で右眼を自傷しているところを家人に発見され，受診した。右眼球結膜はほぼ全周に裂傷があり，対光反応は消失していた。CT検査と術中所見から，明らかなテノン囊，外眼筋，視神経の離開はなく，眼球脱臼のみがあった。眼球摘出後，精神科医と協力し，自傷行為の再発防止と義眼装用をすることができた。

　A 32-year old woman had been under treatment for schizophrenia since one year before. Self-inflicted injury was detected at home by a family member. When seen by us,her right bulbar conjunctiva was lacerated along the whole circumference. Pupillary light reaction was absent. Luxation of the right eyeglobe was diagnosed during surgery. There was no rupture of optic nerve nor of extraocular muscles. We succeeded in further prevention of self-injury and in prescribing prosthesis for the lost right eye under cooperation with a psychiatrist.