I think we should celebrate the fact that such obviously sick individuals will never breed.
Everyone has moments of madness, healthy people are able to suppress the urge to succumb to that madness.
There’s nothing short of the imminent threat of death that would separate me from my testicles. But I can say the same thing about my kidneys or other body parts.
NO, this poor man won’t be breeding, but his illness should still be treated. What happens should he comes to believe his eyes are making him unhappy? Or some other persons eyes?