Bilateral Acute Anterior Uveitis and Optic Disc Edema Following a Snake Bite
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The authors wish to report a case of bilateral acute anterior uveitis and optic disc edema following ahemotoxic snake bite, in order to highlight the concomitant occurrence of these conditions and the potentialadverse effects of anti-snake venom (ASV). A 35-year-old male was bitten by a viper at seventeen thirtyhours, and was started on ASV. Two days following treatment he experienced sudden onset redness andpainful 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), posteriorsynechiae, sluggish and ill-sustained pupillary reaction, and hyperemic, edematous disc with blurredmargins 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 oralprednisolone tapered over 3 weeks, after which VA OU improved, the AC showed no cells and flare anddisc edema resolved. Uveitis and optic disc edema in snake bite can either be due to the direct toxic effectsof the venom or the effect of ASV. Steroids have a beneficial role in the management of these symptoms.
Abstract
The authors wish to report a case of bilateral acute anterior uveitis and optic disc edema following ahemotoxic snake bite, in order to highlight the concomitant occurrence of these conditions and the potentialadverse effects of anti-snake venom (ASV). A 35-year-old male was bitten by a viper at seventeen thirtyhours, and was started on ASV. Two days following treatment he experienced sudden onset redness andpainful 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), posteriorsynechiae, sluggish and ill-sustained pupillary reaction, and hyperemic, edematous disc with blurredmargins 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 oralprednisolone tapered over 3 weeks, after which VA OU improved, the AC showed no cells and flare anddisc edema resolved. Uveitis and optic disc edema in snake bite can either be due to the direct toxic effectsof the venom or the effect of ASV. Steroids have a beneficial role in the management of these symptoms.
참고문헌 (7)
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