AN UNUSUAL PRESENTATION OF SNAKEBITE: BILATERAL VITREOUS HEMORRHAGE

A 27 years old female with history of snakebite on her left leg one month back, presented with complaints of painless, sudden, loss of vision of both eyes which developed 4-5 days after the snakebite. Patient was on treatment for complicated large ulcer over the site of snakebite i.e. left leg and received blood transfusion twice to combat severe anemia due to probable hemotoxic type of snake venom added with blood loss from the ulcer. On ocular examination, visual acuity of right eye was hand movement close to face with accurate projection of rays and left eye visual acuity was perception of light with inaccurate projection of rays. Slit lamp bio-microscopic examination and dilated fundus ophthalmoscopic evaluation revealed vitreous hemorrhage in both eyes which was confirmed in ocular USG B-scan. Patient was advised bed rest, vitamin-C tablets, oral steroids and elective vitrectomy. Subsequently over a period of 6 months, both eyes vitreous hemorrhage reduced to form minimal coagulated clumps and fibrous vitreous materials. Patients vision also improved, in right eye 6/12 and in left eye 6/24.