Dear Sir,We read the case report by Gaur et al.,[1] with great interest. The radiograph of the needles in the facial tissues is the key feature of this photo-essay. Self-inflicted injuries have been reported in psychotic disorders and are known to be associated with first episode psychosis.[2] We are eager to know that whether the patient's psychiatric evaluation suggested that he was under a psychotic spell or he misunderstood the acupuncture technique and inserted needles on his own. We suppose that “aquapuncture”, which authors have mentioned in the text actually meant acupuncture. It is heartening to know that patient's headache subsided completely; however, did that recur after removal of needles? The cause of headache and the way it subsided after piercing needles are something which we are curious to know. As mentioned, all the needles were inserted in the skin around the eyes, so we expect there was no actual globe injury. Any visual morbidity and the visual outcome after the entire episode for the patient need to be explained.The authors have done a commendable job in removing all needles in time. However, a clinical photograph prior to removal of needles would have added to the value of the photo-essay. Timely intervention was important in this case.