![]() ![]() Despite the excellent vision and unconcerning intraocular pressure, there was a strong concern for sclera perforations underlying the visualized conjunctival puncture sites. The intraocular examination was normal, without vitreous hemorrhage, disc edema, retinal hemorrhages, or retinal tears. (A) Closed eyelid of the right rye showing the temporal incisions (white arrow), presumably from the fangs of the Coluber constrictor priapus. (B) Subconjunctival hemorrhage (green arrow) larger under the nasal bulbar conjunctiva. Preoperative Photographs of the Right Eye On the upper eyelid, skin incisions from the presumed snake fangs were visualized on the lateral right eyelid (Figure 1). ![]() The sclera could not be visualized in this area. Puncture sites through the conjunctiva were visualized inferonasally with a few bloody tears present. A near-total subconjunctival hemorrhage, more significant nasally, was visualized in the right eye. Intraocular pressures were noted at 15 and 13 mm of mercury in the right and left eye, respectively, via iCare tonometer (Tiolat Oy, Helsinki, Finland). Anterior chambers were deep in both eyes. On examination, the vision in both eyes was 20/20 without an affect pupillary defect (APD). She immediately told her father who brought her to the hospital directly. The snake, easily identified by the patient as a “Black Racer,” bit her on the right eyelids and eye, prior to being hit away by the patient. She stated that she was lizard hunting with her face near the ground when a snake launched toward her face. Despite this, we encourage careful pursuance of the appropriate therapy on a case-by-case basis, considering operative treatment, antivenom (if necessary), and antibiotic coverage with possible cycloplegia and steroid administration.Ī nine-year-old Caucasian female presented to the emergency department after being bitten in the eye by a snake. Due to very few reported incidences of globe trauma via snake bite, there is no mainstay therapy for either the venomous or nonvenomous snake bite variety. ![]() As such, it is evident that identifying the species of snake is of the utmost importance when considering visual prognosis. All reported cases of nonvenomous cases ultimately resulted in excellent visual potential (20/40 or better) and no reports of endophthalmitis. Methods of treatment include oral or subconjunctival antibiotic administration with or without a steroid or cycloplegic agent. While nonvenomous snake bites may lend a better visual outcome, if not treated properly they may also yield poor final visual potential. Upon literature review, three out of three cases involving venomous snakes resulted in “No Light Perception” vision despite anti-venom. Trauma to the globe via snake bite is an exceedingly rare occurrence. ![]() Throughout multiple follow-ups, she continued to maintain excellent vision without sequelae. Post-operatively, the patient was discharged on a regimen of oral Cephalexin. Circumferential peritomy and direct view to the sclera did not reveal any lacerations or puncture and subconjunctival vancomycin, gentamycin, and dexamethasone were administered intraoperatively. The patient was taken to the operating room emergently for globe exploration. The patient’s vision was unaffected despite visualized puncture wounds through the conjunctiva with associated near-total subconjunctival hemorrhage. In this case report, we describe a nine-year-old girl who presented immediately following a snake bite to the right eye. “We don’t want people just running around killing snakes.Snake bites involving the eye are an uncommon cause of ocular trauma herein, we present one of the few known instances of a snake bite directly to the globe, specifically by the way of a Coluber constrictor, also known as the “Black Racer.” Often the unit requests photos and, if the snake is a Florida native, urges the homeowner to leave it alone or “shoo it away with a broom,” he said. The unit receives two or three calls a day, typically from homeowners unsure what to do about a snake on their property, Miller said. “We’re not in the snake removal business.” But for Lake residents, it will respond to snake calls, mostly to provide information. The venom unit’s key mission is to deliver antivenom, stored at one of the stations, to hospitals around the region to help snake-bit victims. “They were outside, and they went to go back in, and they couldn’t.” The homeowners were pleased when their entryway was again snake-free, he added. ![]()
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