{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:36:30Z","timestamp":1787070990422,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>A 14-year-old male teen presented with unilateral episcleritis, unresponsive to topical and systemic corticosteroid therapy, without a history of ocular trauma or evidence for systemic diseases. The presence of foreign bodies in the conjunctival mucus of the hyperemic fornix has been noticed during one of the follow-up examinations. The toxicological analysis of conjunctival mucus revealed the presence of ethylene glycolmonomethyl ether and triethilene glicolebuthyl ether, used as solvents in nail polish removers and all-purpose cleaners. An unexpected etiology of chemical self-inflicted episcleritis was determined. The teen was admitted to a psychological assessment, after which a psychotherapeutic treatment was recommended. Episcleritis is characterized by the acute onset of ocular pain and redness, with a frequent recurrent and stressful course. Since it can be associated with life-threatening systemic vasculitides, a prompt, aggressive immunosuppressive therapy may be considered, both for the ocular inflammation and for the underlying systemic condition. Rarely episcleritis does not improve despite topical and systemic therapy, administered in a stepladder way. The reported teenager case needed a complex multidisciplinary approach to achieve the correct diagnosis and to avoid unnecessary treatments. In the case of recognized \u201cnonsuicidal self-injury,\u201d a psychological evaluation is strongly recommended, to identify and address underlying neuropsychiatric problems.<\/jats:p>","DOI":"10.4103\/ojo.ojo_209_2016","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T13:37:32Z","timestamp":1716557852000},"page":"55-57","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Ocular nonsuicidal self-injury in a teenager"],"prefix":"10.4103","volume":"11","author":[{"given":"Francesco","family":"Comacchio","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pediatric Ocular Immunology Unit, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ricca","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Neuropsychology Unit, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Martini","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Rheumatology Unit, University of Padua, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Cecchin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Rheumatology Unit, University of Padua, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elisabetta","family":"Zannin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Ocular Immunology Unit, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250925","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/S0161-6420(99)90157-4","article-title":"Severity of episcleritis and systemic disease association","volume":"106","author":"Akpek","year":"1999","journal-title":"Ophthalmology"},{"key":"R2-20250925","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.1016\/S0161-6420(99)90520-1","article-title":"Episcleritis in childhood","volume":"106","author":"Read","year":"1999","journal-title":"Ophthalmology"},{"key":"R3-20250925","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ophtha.2011.07.013","article-title":"Clinical characteristics of a large cohort of patients with scleritis and episcleritis","volume":"119","author":"Sainz de la Maza","year":"2012","journal-title":"Ophthalmology"},{"key":"R4-20250925","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0161-6420(00)00480-2","article-title":"Self-inflicted anterior scleritis","volume":"108","author":"Zamir","year":"2001","journal-title":"Ophthalmology"},{"key":"R5-20250925","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0161-6420(85)34020-4","article-title":"The California syndrome. 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