A Guide to Direct (Peri)ocular Injuries Caused by Snakes: Systematic Review and Treatment Advice

Ocular injuries caused by snakes are very rare, but damage can be severe. There is little evidence on the effective treatment of these injuries. The aim of this systematic review is to discuss all available literature and summarize existing experiences in a treatment advice. In January 2022, a search was performed in the PubMed database. Penetrative trauma by venomous snakebites constitute the most severe cases, and can require the evisceration of the eye. Nonvenomous snakes, mostly boas and pythons held in captivity, are also able to perforate the eye, though with a more favorable disease course. Chemical trauma by inoculation of venom occurs as well, and copious irrigation is advised in these cases. Detailed suggestions for ophthalmologic treatment are presented.