Optic Neuritis After a Snakebite: A Diagnostic Dilemma.

Area of Science:

• Neurology
• Toxicology
• Ophthalmology

Background:

• Snakebite envenoming is a significant public health issue in India, leading to considerable morbidity and mortality, especially in rural areas.
• Elapidae snakes, including the cobra and common krait, are primarily responsible for neurotoxic effects, often resulting in acute neuromuscular weakness and respiratory compromise.

Observation:

• A 24-year-old female presented with unresponsiveness after a snakebite, requiring intubation and mechanical ventilation.
• Following initial improvement with antivenom and anticholinesterase agents, the patient developed blurred vision and slurred speech on day 6, indicative of bilateral optic neuropathy.

Findings:

• The patient was treated with repeat snake antivenom and steroids for optic neuritis, leading to significant clinical improvement.
• Discharge occurred on day 14, demonstrating the efficacy of timely and comprehensive management for this rare snakebite complication.

Implications:

• While antivenom is crucial for snakebite management, clinicians must remain vigilant for potential neurological and ophthalmological complications.
• Optic neuritis following snakebite, though uncommon, necessitates early recognition and aggressive treatment with steroids and antivenom for favorable outcomes.
• This case underscores the importance of identifying the snake species and considering rare adverse events in the clinical suspicion and management of snakebite victims.