Ocular digital phenomenon

The oculodigital phenomenon (from the Latin oculus “the eye” and digitalis “belonging to the finger”), also called “eye drilling ” or “digito-ocular sign” , is a stereotypical behavior (a “ blindism ”) in blind and severely visually impaired children. By pressing on the eyes, the children are likely to provoke light phenomena like stars to stimulate their brains .

Eye drilling can be carried out in different variants:

The whole fist, the knuckle or individual fingers are pressed against the eye.
A toy serves as an auxiliary tool.
Fingers are pressed between the eyeball (globe) and the orbit (eye socket).
The head is tilted forward while sitting and the eyes are pressed onto the wrists.

The oculodigital phenomenon can be viewed as bad for outsiders, but is generally not harmful for the affected child.

causes

The oculodigital phenomenon is still largely unexplored. However, it is common in infants and children who are blind or severely visually impaired. One speaks of a severe visual impairment up to a maximum visual acuity (visual acuity) of 0.05 on the better eye. Eye disorders in which the oculodigital phenomenon can be observed include:

Microphthalmia : The eye is very small or only rudimentary.
Retinal detachment : The inner parts of the retina detach from the retinal pigment epithelium.
Retinal dystrophies : Congenital dysfunction of the retina .
A missing connection between the optic nerve and the visual center .
Retinopathia prematurorum : The incomplete maturation of vessels of the retina in premature infants.

The oculodigital phenomenon occurs especially in congenital or very early acquired visual disorders . But children with autism also bore their eyes.

Symptoms

The main symptom of the oculodigital phenomenon is a stereotypical process in which the visually impaired children drill their eyes. The eye drilling can take several seconds to minutes. For most of those affected, the stereotype begins after eight to ten months of life and disappears on its own in kindergarten. Concomitant
symptoms can be a loss of orbital fat and a sinking back of the eyeballs into the eye sockets ( enophthalmos ). However, this is not dangerous, at most a cosmetic problem.

purpose

Presumably the eye drilling serves to trigger so-called entopic phenomena . This is understood to mean subjective optical perceptions such as asterisks or geometric figures that are formed within the visual center and that only the person concerned can see.
When the children perceive an ocular digital phenomenon such as a flash of light through the drilling of their eyes, they supply their brain with an optical stimulus that they would otherwise have to do without because of their blindness. The brain is stimulated visually and can be stimulated, for example, when it is under-challenged (" arousal " approach).
Further theories about the meaning of stereotypes in the blind are currently being discussed with regard to the oculodigital phenomenon.

Handling

Many of those affected were banned from eye drilling in childhood, sometimes with drastic penalties. This can lead to psychological problems in the children, who are sometimes unable to understand the prohibition due to their age.
While eye drilling in infants and children often frightens outsiders, it is basically harmless. Sinking back of the eyeball into the eye socket is not dangerous and at most a cosmetic problem.

Parents and carers should therefore be lenient with their children. A ban on eye drilling is not necessary according to the current state of knowledge. If, in addition to eye drilling, there are other stereotypes such as rocking or banging the head, a visit to a behavioral psychologist who specializes in the blind is recommended.

Demarcation

Although very rare, can occur at any age and often in people with intellectual disabilities a self-injury of an eye (behavior to self Distance Autoenukleation ) occur. Which the okulodigitalen phenomenon is to distinguish the differential diagnosis.

literature

Lienert, Dana: Eye drilling in blind people. - An examination of the theories of scientists and affected people with an approach to weaning. Diploma thesis, Magdeburg 2007.
various authors: Pschyrembel. Clinical Dictionary. 263rd, revised edition. Walter de Gruyter, Berlin 2012, p. 1613.
Elmar Oestreicher: ENT, ophthalmology, dermatology and urology for nursing professions. Georg Thieme Verlag, Stuttgart 2003, p. 141.
Gerhard Lang: Ophthalmology. Georg Thieme Verlag, Stuttgart 2011, p. 146.

Web links

Individual evidence

↑ Gamulescu et al .: Enucleation as a form of autoaggression. In: Clinical monthly sheets for ophthalmology. Vol. 218, No. 6, 2001, pp. 451-454, here p. 452; see. Patton: Self-inflicted eye injuries: a review. In: Eye. Vol. 18, No. 9, 2004, pp. 867-872, here p. 869, where a correlation of pediatric cases of self-harm to the eye with Tourette's syndrome and Lesch-Nyhan syndrome is established; however, the inclusion of these syndromes is described by Khan et al .: Medical Management of Self-Enucleation. In: Archives of Ophthalmology. Vol. 103, No. 3, 1985, pp. 386-389, here p. 388, characterized as incorrect. See also Fan: Autoenucleation. In: Psychiatry. Vol. 4, No. 10, 2007, pp. 60-62, here p. 61.

[1] Gamulescu et al .: Enucleation as a form of autoaggression. In: Clinical monthly sheets for ophthalmology. Vol. 218, No. 6, 2001, pp. 451-454, here p. 452; see. Patton: Self-inflicted eye injuries: a review. In: Eye. Vol. 18, No. 9, 2004, pp. 867-872, here p. 869, where a correlation of pediatric cases of self-harm to the eye with Tourette's syndrome and Lesch-Nyhan syndrome is established; however, the inclusion of these syndromes is described by Khan et al .: Medical Management of Self-Enucleation. In: Archives of Ophthalmology. Vol. 103, No. 3, 1985, pp. 386-389, here p. 388, characterized as incorrect. See also Fan: Autoenucleation. In: Psychiatry. Vol. 4, No. 10, 2007, pp. 60-62, here p. 61.