Penetrating ocular injury caused by venomous snakebite

To report the case of a patient who experienced a penetrating ocular injury with direct intraocular injection of venom from a snakebite.

Case report.

A 34-year-old man was bitten by a snake on his right eye. The snake was identified as Deinagkistrodon acutus. Antivenom was provided, but facial swelling, periorbital ecchymoses, massive subconjunctival hemorrhage, severe corneal edema, and exophthalmos of the right eye were noted. Dyspnea due to airway edema then developed.

He received emergent intubation. Evisceration was performed, and a continuously active bleeding scleral wound was found. No local infection developed under systemic and topical antibiotics. Pathologic examination of the excised cornea showed necrosis on the endothelial side.

Early evisceration was the treatment of choice for treatment of a penetrating ocular injury caused by venomous snakebite. Maintaining stable life signs and prevention of infection remained the major concerns.