AN UNUSUAL PRESENTATION OF TRICHOTILLOMANIA AND MUCUS FISHING SYNDROME IN A PATIENT WITH OBSESSIVE COMPULSIVE DISORDER EXACERBATED BY AMPHETAMINE USE

Title AN UNUSUAL PRESENTATION OF TRICHOTILLOMANIA AND MUCUS FISHING SYNDROME IN A PATIENT WITH OBSESSIVE COMPULSIVE DISORDER EXACERBATED BY AMPHETAMINE USE
Author, Co-Author Molly Cardenal, Deborah Williams
Topic
Year
2010
Day
Friday
Program Number
105888
Room
Third Floor Foyer
Affiliation
Abstract BACKGROUND: Background: Trichotillomania (TTM) is hair loss from a patient’s repetitive self-pulling of hair, resulting in bald patches. Mucus fishing syndrome (MFS) is a cascading cyclic condition characterized by continuous extraction of mucus strands from the eye. Obsessive compulsive disorder (OCD) is an anxiety disorder and is characterized by recurrent, unwanted thoughts and/or repetitive behaviors. The association between both TTM and MFS with OCD is discussed and treatment options reviewed.

CASE REPORT(S): Case study: A 52 year old female presented for a referral from primary care due to conjunctivitis OS and concern that she was damaging her eyelid. She also reported an extreme concern for excessive mucus "compressing" her eye and causing blindness. She was also concerned about damaging her eyelid from pulling out her lashes. Upon examination, her VA OD 20/30, OS 20/40 she had mucopurulent discharge OS with injection, chemosis, and staining. There was also profound loss of both superior and inferior lashes. Ofloxacin was prescribed and artificial tears were recommended PRN. The diagnosis was MFS and TTM and she was referred to the mental health clinic. Over the next few weeks, she returned many times with the same complaint and increasing agitation. She stated she was unable to stop the behavior. Over the next week, VA decreased from 20/40 to 20/60 due to the corneal surface. After a long discussion, she requested inpatient psychiatric care. While admitted, she indicated she had been using amphetamines. Counseling, medication, and electroshock therapy were used to treat this episode of obsessive compulsive mania. Follow-up visits after her psychological treatment showed remarkable improvement in ocular health.

CONCLUSIONS: Conclusion: When treating patients with MFS and TTM, their mental health should be considered to make proper referrals for treatment. The association between these conditions and therapeutic options will be discussed.
Affiliation of Co-Authors Pacific University, College of Optometry
Outline