Cyanoacrylate repair of laser in situ keratomileusis corneal flap perforation by a snake bite

Abstract

A 30-year-old man who had laser in situ keratomileusis (LASIK) for myopia 1 year earlier developed a corneal perforation in the left eye from a boa constrictor. The patient presented to the emergency room, and a small corneal perforation just outside the visual axis was diagnosed within the LASIK flap. Cyanoacrylate adhesive was used to close the corneal perforation. The patient went on to full visual recovery with an uncorrected visual acuity of 20/20. This is the first reported case of a penetrating corneal injury from a serpent in an eye that had LASIK. Cyanoacrylate may be used to repair small traumatic corneal perforations with a favorable visual outcome in eyes that have had LASIK.

Challenges in the management of ocular snake-bite injuries

“…Direct inoculation of venom into the eye has been known to cause globe necrosis, keratomalacia and uveitis, often ending up requiring evisceration or enucleation [9,10]. Direct ocular trauma from the bite of a non-venomous Boa constrictor has also been reported [11][12][13]. This is the first ever reported case of ocular trauma inflicted by a python species.…”

Challenges in the management of ocular snake-bite injuries

“…Direct inoculation of venom into the eye has been known to cause globe necrosis, keratomalacia and uveitis, often ending up requiring evisceration or enucleation [9,10]. Direct ocular trauma from the bite of a non-venomous Boa constrictor has also been reported [11][12][13]. This is the first ever reported case of ocular trauma inflicted by a python species.…”

Coluber Constrictor Bite to the Eye: A Novel Case Report of a Wild Snake Bite to the Eye in North America and Review of Literature

“…The range of complications from snake bites to the eye is largely dependent on the extent of damage and whether the snake is venomous or nonvenomous. This is the first reported case of a wild snake in North America directly biting the eye, as the four cases of penetrating globe injuries reported thus far in North America have been by pet snakes [1][2][3][4].…”

A Guide to Direct (Peri)ocular Injuries Caused by Snakes: Systematic Review and Treatment Advice

“…Seven reports of patients bitten by a nonvenomous snake were retrieved (Table 2). 7,8,[13][14][15][16][17] One young patient was bitten by a wild colubrid. The other six pertained to snakes held in captivity, and all involved a corneal perforation.…”

“…Four cases were caused by a captive boa constrictor (Boa constrictor, Figure 3). [13][14][15][16] The most remarkable one was an 18-year-old male from the United States that was struck on the right-side of his face while bathing his almost 2-m-long pet snake. 13 He partially deflected the attack with his hand, but the boa got a firm grip on both his hand and lower eye lid, and wrapped around his neck.…”

“…15 A 30-year-old male from the United States suffered a pinpoint, Seidel positive corneal perforation that went through a 1-year-old laser in situ keratomileusis (LASIK) flap, after his pet boa attacked him. 16 The flap was not dislocated and did not show striae and the wound was repaired using cyanoacrylate glue and a bandage contact lens.…”

Challenges in the management of ocular snake-bite injuries

“…Direct inoculation of venom into the eye has been known to cause globe necrosis, keratomalacia and uveitis, often ending up requiring evisceration or enucleation [9,10]. Direct ocular trauma from the bite of a non-venomous Boa constrictor has also been reported [11][12][13]. This is the first ever reported case of ocular trauma inflicted by a python species.…”

Coluber Constrictor Bite to the Eye: A Novel Case Report of a Wild Snake Bite to the Eye in North America and Review of Literature

“…The range of complications from snake bites to the eye is largely dependent on the extent of damage and whether the snake is venomous or nonvenomous. This is the first reported case of a wild snake in North America directly biting the eye, as the four cases of penetrating globe injuries reported thus far in North America have been by pet snakes [1][2][3][4].…”

A Guide to Direct (Peri)ocular Injuries Caused by Snakes: Systematic Review and Treatment Advice

“…Seven reports of patients bitten by a nonvenomous snake were retrieved (Table 2). 7,8,[13][14][15][16][17] One young patient was bitten by a wild colubrid. The other six pertained to snakes held in captivity, and all involved a corneal perforation.…”

“…Four cases were caused by a captive boa constrictor (Boa constrictor, Figure 3). [13][14][15][16] The most remarkable one was an 18-year-old male from the United States that was struck on the right-side of his face while bathing his almost 2-m-long pet snake. 13 He partially deflected the attack with his hand, but the boa got a firm grip on both his hand and lower eye lid, and wrapped around his neck.…”

“…15 A 30-year-old male from the United States suffered a pinpoint, Seidel positive corneal perforation that went through a 1-year-old laser in situ keratomileusis (LASIK) flap, after his pet boa attacked him. 16 The flap was not dislocated and did not show striae and the wound was repaired using cyanoacrylate glue and a bandage contact lens.…”

Challenges in the management of ocular snake-bite injuries

“…Direct inoculation of venom into the eye has been known to cause globe necrosis, keratomalacia and uveitis, often ending up requiring evisceration or enucleation [9,10]. Direct ocular trauma from the bite of a non-venomous Boa constrictor has also been reported [11][12][13]. This is the first ever reported case of ocular trauma inflicted by a python species.…”

Coluber Constrictor Bite to the Eye: A Novel Case Report of a Wild Snake Bite to the Eye in North America and Review of Literature

“…The range of complications from snake bites to the eye is largely dependent on the extent of damage and whether the snake is venomous or nonvenomous. This is the first reported case of a wild snake in North America directly biting the eye, as the four cases of penetrating globe injuries reported thus far in North America have been by pet snakes [1][2][3][4].…”

A Guide to Direct (Peri)ocular Injuries Caused by Snakes: Systematic Review and Treatment Advice

“…Seven reports of patients bitten by a nonvenomous snake were retrieved (Table 2). 7,8,[13][14][15][16][17] One young patient was bitten by a wild colubrid. The other six pertained to snakes held in captivity, and all involved a corneal perforation.…”

“…Four cases were caused by a captive boa constrictor (Boa constrictor, Figure 3). [13][14][15][16] The most remarkable one was an 18-year-old male from the United States that was struck on the right-side of his face while bathing his almost 2-m-long pet snake. 13 He partially deflected the attack with his hand, but the boa got a firm grip on both his hand and lower eye lid, and wrapped around his neck.…”

“…15 A 30-year-old male from the United States suffered a pinpoint, Seidel positive corneal perforation that went through a 1-year-old laser in situ keratomileusis (LASIK) flap, after his pet boa attacked him. 16 The flap was not dislocated and did not show striae and the wound was repaired using cyanoacrylate glue and a bandage contact lens.…”