Enucleation is the complete gouging of another person’s eye. Accounts of enucleation in the research literature are sparse, but accounts of self-enucleation may be found frequently in the medical literature. In the case presented here, a 20 year old male who had recently entered military service began to become fearful when he perceived his fellow recruits to be acting strangely. Upon seeking help at the infirmary, he believed he was in the presence of the devil and attacked the non-commissioned officer he had sought help from. The assault enucleated the officers’ right eye and seriously injured the left eye, causing it to be surgically enucleated. Clinical interviews with the subject and reviews of his hospitalization records led to the conclusion that the male subject was suffering from a delusional disorder with religious and demonic content, visual and auditory hallucinations, illusion phenomena, command experiences, delusional interpretations, imaginative elements, and feelings of terror at the time of the attack. The psychiatric forensic investigation resulted in a DSM-IV diagnosis of paranoid schizophrenia, possibly caused by hydrocephalus and aqueductal stenosis. Only a few previous cases have linked hydrocephalus, aqueductal stenosis, and schizophrenic psychosis. Psychiatrists should be aware that there is an increased risk of committing serious aggressive acts when a patient suffers from persecutory delusions. Figure, references