Self-enuclation is a rare but tragic consequence of a severe mental disorder and it is strongly associated with the symptoms of religious delusions, pathological guilt, auditory hallucinations and delusions specifically relating to the eye. In the case of unilateral or incomplete self-enucleation the risk of further eye injury remains high. In the situation of attempted enucleation the only way to prevent blindness may be one-to-one nursing and physical restraint (including finger and chest/body). In this report, we describe a case of self-enuclation under physical restraint which highlights the difficulties of management.
