Uveitis following anti-snake venom therapy

Nayak, Sunil S; Satish, Renuka; Nityanandam, S.; Thomas, Roanne

doi:10.1590/s1678-91992007000100010

Cited by 11 publications

(9 citation statements)

References 1 publication

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“…The response to systemic steroids also favours an immune response as the pathogenic mechanism for this uveitis. 20 In present study, the fibrinoid anterior uveitis , hypotony and vitritis developed within 4 days unlike in S Nayak et al…”

Section: Discussioncontrasting

confidence: 48%

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

George¹,

Asha²,

Ravindran³

et al. 2017

Int J Res Med Sci

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Background: Snake bite is a neglected public health problem worldwide especially in the tropics. Studies on ocular manifestations are still fragmentary. The objective of the study was to find ocular manifestations among the snake bite cases with systemic envenomation admitted in the intensive care units in a tertiary care hospital in rural North Kerala, India during a period of 4 years from May 2012 to May 2016.Methods: It was a prospective, observational, cross sectional study. Institutional ethical committee approval was obtained for the study. A descriptive analysis of snake bite cases with systemic envenomation was done. Other snake bites are excluded from the study. Patients who needed ophthalmological opinion for ocular symptoms were analyzed.Results: Total suspected snake bites admitted in ICUs during the study period were 638. Only 7 patients (1%) with haematotoxic envenomation needed ophthalmological opinion for ocular symptoms. Patients in the present study ranged between the age of 11 and 53. Ocular lesions diagnosed among the 6 patients who developed capillary leak syndrome, were bilateral angle closure glaucoma in 3 patients, pan uveitis, disc edema and retinal haemorrhages in 2 patients, bilateral macular oedema. Youngest patient had intracranial haemorrhage and bilateral orbital hemorrhage, leading to exposure keratitis. SAV was administered in all patients ranging from 11-30 vials. All the patients except the patient with orbital haemorrhage had a grave prognosis. Still only one of these patients expired on day 3, rest all patients had better vision and survived due to timely management.Conclusions: A timely intervention especially at the initial presentation of capillary leak syndrome, can decrease the morbidity and save the life of a patient.

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Section: Discussioncontrasting

confidence: 48%

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

George¹,

Asha²,

Ravindran³

et al. 2017

Int J Res Med Sci

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“…Late onset uveitis following venomous bite is probably due to serum sickness like response to horse ASV serum. 14 In the present study common ocular manifestations of neurotoxic snake bites were ptosis followed by diplopia, ophthalmoplegia and optic neuritis, in order of decreasing incidence. Seneviratne U et al 15 in their study of 56 patients with neurological manifestations of snake bite, reported that ptosis and ophthalmoplegia were the commonest neurological manifestations Singh J et al, 3 in an analysis of 33 venomous snake bites in a military operational area of north India reported 21 patients to be neurotoxic in nature.…”

Section: Discussionsupporting

confidence: 47%

Ocular Manifestation and Long Standing Visual Impairment Following Venomous Snake Bite

Das¹,

Samaddar²,

Jana³

2015

jemds

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OBJECTIVE: Snake bite is an environmental hazard associated with significant ocular morbidity and some have sight threatening complications. Objective of this study was to determine the ocular manifestations and long standing visual impairment following snake bite and to acquaint the ophthalmologists and related health professionals about the sight threatening ocular complications related to snake bite. METHODS: Prospective data was collected from the Dept. of Internal Medicine, Burdwan Medical College, a rural based tertiary care hospital in eastern India. All snake bite patients admitted in the Department of Internal Medicine were examined and all patients with ocular manifestations were included in the study. RESULTS: Out of 245 cases of snake bite, 51(27.27%) cases of venomous snake bite with ocular findings were included in this study. Thirty three (64.71%) out of 51 were vasculotoxic and 18(35.29%) were neurotoxic in nature. Commonest ocular manifestation of neurotoxic bite was ptosis, followed by diplopia, ophthalmoplegia and optic neuritis. In vasculotoxic snake bites retinal and vitreous hemorrhage (36.36%) was most common followed by subconjunctival hemorrhage and chemosis (27.28%), lid oedema (18.18%), hyphaema (12.12%) and anterior uveitis (6.06%). Causes of long standing visual impairment were retinal hemorrhage in one patient and vitreous hemorrhage in two patients. CONCLUSIONS: Ocular morbidity following snake bite were more common among young males. Majority of long standing visual impairment were associated with vasculotoxic snake bite and required long term follow-up.

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“…Snake bite related ocular complications have been rarely reported in the literature, the common problem described after snakebite is in the form of ophthalmoplegia 6 . Other ocular manifestations as effects of snakebite reported as keratomalacia, macular infarction, including haemorrhages into the conjunctiva, anterior chamber, lid oedema, conjunctival chemosis, retinal and optic nerve oedema, optic neuritis, and optic atrophy, globe necrosis and visual loss due to cortical infarction, uveitis and endophthalmitis [7][8][9][10] . In this case, vision loss is due to bilateral retinal haemorrhage and cotton wool spot subsequent to the snakebite.…”

Section: Discussionmentioning

confidence: 99%

A Case of Bilateral Retinal Hemorrhage with Cotton Wool Spot Following Viper Bite

Jana¹,

Chaudhuri

Ganguly

et al. 2015

Bangladesh J Med Sci

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Abstract:A 38 years male, admitted in the department of Internal Medicine with a history of snake bite in his left lower leg during agriculture work. He was treated with anti snake venom after admission. He had history of dimness of vision in both eyes. On examination, swelling and subcutaneous hemorrhage was noted in his left leg. His best corrected visual acuity (BCVA) was 6/60 in the both eyes. Fundus examination with 90 D lens and Indirect Ophthalmoscopy of both eyes showed retinal hemorrhage with cotton wool spots. Blood tests revealed increased titers of D-dimer and fibrin degradation products. The patient was followed up regularly at 2 weeks interval and BCVA and Fundus examination was carried out. At the end of 10 weeks, retinal hemorrhages had significantly cleared in both eyes with improvement of vision in both eyes (BCVA of right eye at last follow-up 6/6 and left eye 6/9).

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Uveitis following anti-snake venom therapy

Cited by 11 publications

References 1 publication

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

Ocular Manifestation and Long Standing Visual Impairment Following Venomous Snake Bite

A Case of Bilateral Retinal Hemorrhage with Cotton Wool Spot Following Viper Bite

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