Bilateral Acute Anterior Uveitis and Optic Disc Edema Following a Snake Bite

Abstract

The authors wish to report a case of bilateral acute anterior uveitis and optic disc edema following a hemotoxic snake bite, in order to highlight the concomitant occurrence of these conditions and the potential adverse effects of anti-snake venom (ASV). A 35-year-old male was bitten by a viper at seventeen thirty hours, and was started on ASV. Two days following treatment he experienced sudden onset redness and painful diminution of vision in both eyes (OU). On examination, the patient's visual acuity (VA) in OU was 20/200. Examination revealed fresh keratic precipitates, cells, and flare in the anterior chamber (AC), posterior synechiae, sluggish and ill-sustained pupillary reaction, and hyperemic, edematous disc with blurred margins in OU. He was started on topical steroids, cycloplegics and intravenous methylprednisolone. Following treatment, the patient showed improvement and was continued on topical medications and oral prednisolone tapered over 3 weeks, after which VA OU improved, the AC showed no cells and flare and disc edema resolved. Uveitis and optic disc edema in snake bite can either be due to the direct toxic effects of the venom or the effect of ASV. Steroids have a beneficial role in the management of these symptoms.

Orbital cellulitis and pyogenic meningitis rare sequelae after snake bite

“…Steroids play a beneficial role in the management of these symptoms. 16 Rao in 1981 reported the immediate development of blindness after a cobra bite and recognized it to the lethal influence of the venom per se. 17 Mathur described a case of nonpoisonous snake bite that developed optic neuritis following administration of ASV.…”

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

“…18 A similar case of anterior uveitis and optic disc edema following haematotoxic bite reported from South India was considered as an adverse effect of SAV or a direct toxic effect of the venom. 19 Their patient was treated with steroids and intra venous methyl prednisolone with visual improvement and resolution of disc edema. S Nayak et al had reported on uveitis following SAV in 2 patients.…”