Adder bite on eyelid along with retained intraorbital fangs

Area of Science:

• Ophthalmology
• Toxicology
• Herpetology

Background:

• Snake envenomation, particularly involving the ocular adnexa, is uncommon.
• Most reported cases involve large constrictor snakes, making viperid bites exceedingly rare.

Observation:

• A 57-year-old male presented with a firm, tender lump on his left upper eyelid 12 days post-adder (Vipera berus) bite.
• The patient recalled the bite occurring while he was on his farm.

Findings:

• Computed tomography (CT) scan identified a calcified foreign body, consistent with an adder's tooth, in the superomedial orbit.
• The foreign body measured approximately 5 mm and was located extracònally.

Implications:

• This case underscores the potential for retained intraorbital foreign bodies following snakebites to the eyelid.
• Accurate diagnosis and management are crucial for favorable clinical outcomes in rare snakebite presentations.