Korean J Ophthalmol.  2014 Apr;28(2):186-188. 10.3341/kjo.2014.28.2.186.

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

• Kumar PK
• Ahuja S
• Kumar PS

• KMID: 1792115
• DOI: http://doi.org/10.3341/kjo.2014.28.2.186

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.

Keyword

Edema of the optic disc; Snake bites; Uveitis

MeSH Terms

Acute Disease
Adult
Antivenins/*adverse effects
Glucocorticoids/administration & dosage
Humans
Hyperemia/drug therapy/etiology/pathology
Male
Methylprednisolone/administration & dosage
Papilledema/drug therapy/*etiology/pathology
Snake Bites/*complications/*therapy
Uveitis, Anterior/drug therapy/*etiology/pathology
Antivenins
Glucocorticoids
Methylprednisolone

Figure

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  Fig. 1 (A) Slit lamp photograph of the right eye showing posterior synechiae at the 3 o'clock position. (B) Slit lamp photograph of the left eye showing posterior synechiae at the 11 o'clock position.

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  Fig. 2 Fundus photographs of the left (A) and right eye (B) showing hyperemia and blurred margins, with edema of the optic nerve head.

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