Self-inflicted ocular injuries in children.

Ocular damage resulting from self-mutilation is not uncommon in severely retarded children. Such injuries are caused by repeated headbanging or self-inflicted blows to the face. We treated four children with self-inflicted ocular injuries ranging from corneal lacerations to vitreous hemorrhage and retinal detachment. One child, a 14-year-old boy with tuberous sclerosis, became blind. Persons caring for such children should be alert to changes in the appearance of the pupil, changes in the personality or performance level of the child, and to the development of exotropia. Early treatment and protective equipment (spectacles or helmets) may prevent permanent injury.