Self Mutilation with Bilateral Rhegmatogenous Retinal Detachment in Tourette’s Syndorme Treated with Pars Plana Vitrectomy

Gilles de la Tourette’s syndrome, or Tourette’s syndrome (TS), is a neurodevelopmental condition characterized by multiple motor and vocal tics, which appear in childhood and are often accompanied by behavioral symptoms [1]. The chronic presence of at least two motor tics and one vocal tic since childhood is recognized as the key feature of Tourette’s syndrome [1,2]. Motor tics (facial grimacing, arm jerking, punching, blinking, alterations in gaze, rubbing of the eyes, blepharospasm, etc.) are well known as early manifestations of TS [3]. There are isolated reports, which associate this syndrome with color vision deficiencies, self-induced vitreous hemorrhage, and dislocation of crystalline lens, retinal detachment and keratoconus [4,5]. The early ocular manifestations are easily missed, as these patients are too embarrassed to complain about the visual symptoms. A delay in diagnosis of retinal detachment is not good as the RD can progress to PVR and visual prognosis in PVR cases is poor even after multiple VR procedures [6-8]. In this article, we report a case of bilateral retinal detachment in a patient with TS that resulted as a consequence of repeated punching of periorbital region by hand.