Retinal detachment to chronic self-injurious behavior

NEW PUBLICATION – We know that many of our children often poke and rub their eyes for no apparent reason. We parents suspect that it may help them to see more clearly (children with BOS are often severely near-sighted). Another theory is that eye poking is a sensory stimulation (creates light flashes) (when bored or as a distraction when there is pain). This study describes a retinal detachment secondary to chronic self-injurious behaviour.


A 9-year-old female with a history of Bohring-Opitz syndrome (BOS), Down syndrome, and autism initially presented with bilateral cataracts and a total retinal detachment in her left eye secondary to chronic self-injurious behavior. The authors report the first case of self-induced retinal detachment and traumatic cataracts in a patient with BOS. For patients who present with self-injurious behavior, the authors advocate for behavioral modifications at home, including the use of “no-no’s,” supplemental medication if necessary, and behavioral therapy to reduce the risk of self-induced visual injury. The authors also suggest the use of 25-gauge vitrectomy with silicone oil for retinal detachment repair. Finally, given the high risk of irreversible vision loss from amblyopia and recurrent retinal detachments in children with BOS and self-injurious behavior, the authors recommend regular 2-month interval ophthalmic follow-up.

Madeline Hanes; Effie Z. Rahman, MD; Robert W. Wong, MD; C. Armitage Harper III, MD: Self-Induced Bilateral Retinal Detachments and Traumatic Cataracts in a Patient With Bohring-Opitz Syndrome Published Online:July 01, 2021.