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


METHODS
Case report.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Chen
Chien-Chung
CC
Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, 707 Section 3 Chung Yang Road, Hualien, Taiwan 970.
Yang
Chung-May
CM
Hu
Fung-Rong
FR
Lee
Yuan-Chieh
YC
D000328:Adult; D017836:Agkistrodon; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D003229:Conjunctival Diseases / Q000209:etiology; D015715:Corneal Edema / Q000209:etiology; D003435:Crotalid Venoms / Q000506:poisoning; D004438:Ecchymosis / Q000209:etiology; D017234:Eye Evisceration; D005130:Eye Hemorrhage / Q000209:etiology; D015807:Eye Injuries, Penetrating / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D012590:Sclera / Q000293:injuries* / Q000473:pathology; D012909:Snake Bites / Q000150:complications* / Q000473:pathology
D000997:Antivenins; D003435:Crotalid Venoms