Table 2.
Ocular complications following snake venom injection.
| Species | Sex/Age | Other Symptoms | Presuming Venom Components |
* Possible Direct Mechanism # Possible Indirect Mechanism |
Antivenom/ Amount |
Outcome | Ref. | |
|---|---|---|---|---|---|---|---|---|
| Anterior segment manifestations | ||||||||
| Subconjunctival hemorrhage | Unknown | M/70 | Acute renal failure | SVMPs | * Proteolytic effect | IV Antivenom/ 16 vials | Recovery | [35] |
| Corneal striae, anterior pseudohypopyon, cataract |
Unknown | M/70 | Acute renal failure | Hemotoxin | # Secondary of subconjunctival hemorrhage and side effect of antivenom | IV Antivenom/ 16 vials | Remain corneal striae and cataract | [35] |
| Cataract | Unknown | M/60 | AMS | SVMPs | # Anterior inflammation caused by vitreous hemorrhage | IV Antivenom/ Unclear | NLP | [36] |
| Iris atrophy, Cataract | Unknown | M/55 | Anasarca | Cytotoxin | * Anterior ischemia | IV Antivenom/ Unclear | IMC | [36] |
| Iris atrophy, Cataract | Unknown | M/45 | Limb edema | Cytotoxin | * Anterior ischemia | IV Antivenom/ Unclear | Lost for follow-up | [36] |
| Posterior segment manifestations | ||||||||
| CRAO | Unknown | M/26 | Headache | Hemotoxin | * Coagulopathy | Unclear | Reduction of vision | [32] |
| CRAO | Unknown | M/24 | Bleeding diathesis | Hemotoxin | * Coagulopathy | As above | Reduction of vision | [32] |
| CRAO | Viper | F/30 | AMS | Hemotoxin, | * Coagulopathy | IV Antivenom/ Unclear | Poor visual prognosis | [30] |
| CRAO | Viper | F/17 | n/a | Hemotoxin | * Coagulopathy | IV Antivenom/ Unclear | Lost for follow-up | [29] |
| Retinal or vitreous hemorrhage | Viper | F/17 | AMS | SVMPs | * Proteolytic effect | IV Antivenom/ Unclear | NLP | [33] |
| Vitreous hemorrhage | Viper | M/60 | AMS | SVMPs | * Proteolytic effect | IV Antivenom/ Unclear | 20/200 for O.U. | [36] |
| Macular infarction | Viper | F/17 | AMS | Hemotoxin | * Thrombosis | IV Antivenom/ Unclear | NLP | [33] |
| Retinal detachment | Unknown | F/13 | Vitreous hemorrhage | SVMPs | * Hemorrhage-induced subretinal edema | IV Antivenom/ Multiple dose |
20/200 for O.S. Reduction of vision for O.D. | [34] |
| Glaucoma | ||||||||
| AACG | Unknown | M/70 | Acute renal failure | Hemotoxin Neurotoxin |
# Capillary leak due to hematoxin * Ophthalmoplegia due to neurotoxin |
IV Antivenom/ 16 vials | Lost for follow-up | [35] |
| AACG | Vipera lebetina | F/67 | AMS | Hemotoxin, Neurotoxin | * Coagulation cascade and synapse disorder | IV Antivenom/ Unclear | BCVA is 5/10 for O.S. | [39] |
AMS: Altered mental status; SVMPs: Snake venom metalloproteinases; NLP: No light perception; IMC: Immature cataract; BCVA: Best corrected visual acuity.