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ARTICLES
Year : 1978  |  Volume : 26  |  Issue : 3  |  Page : 16

Bilateral blindness following snake bite


Patna Medical College Hospital, Patna, India

Correspondence Address:
Akhouri Shashi Bhushan Sahai
Patna Medical College Hospital, Patna
India
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Source of Support: None, Conflict of Interest: None


PMID: 738773

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How to cite this article:
Bhushan Sahai A, Sinha R. Bilateral blindness following snake bite. Indian J Ophthalmol 1978;26:16

How to cite this URL:
Bhushan Sahai A, Sinha R. Bilateral blindness following snake bite. Indian J Ophthalmol [serial online] 1978 [cited 2020 Jun 1];26:16. Available from: http://www.ijo.in/text.asp?1978/26/3/16/31189

Poisonous snakes occur in many parts of the world and are especially prevalent in the tropics. Most of the snakes secrete venom which contains both neurotoxic and haemotoxic factors. The venom of cobras is usually neuro­toxic and that of vipers is haemotoxic.


  Case-Report Top


B. Devi aged 35 years hindu female following snake bite came to Eye O.P.D. of Patna Medical College Hospital with the complaint of bilateral blindness. She gave the history that while working in her village ten months ago she was bitten by a snake on the right thumb Following that she became unconscious She was treated at the local dispensary, where antisnake venom was given alongwith other drugs. Then after a week she was admitted in the medical ward of Patna Medical College Hospital in unconscious state where she stayed for two months. She gained conscious­ness after a fortnight and found herself blind with generalised muscular weakness. She remained there for two months. Her detailed medical records could not be obtained.

On external examination vision of both the eyes was hand movement only. Ocular movement was full in all directions. Pupillary reaction was sluggish in both the eyes. Tension was normal. Ophthalmoscopy showed pale disc with hazy margin.

The routine investigation (haemogram, urine and stool) were non-contributory, x-ray skull did not show any abnormality. Blood sugar and W.R. were normal. She was given retrohulbar injection of 1 cc. Dexamethas­one (4 mg.) on every alternate day in each eye for three weeks along with I.M. injection of Neurobion. But the patient even after this treatment did not show any improvement.


  Discussion Top


Ocular complications following snake bite is relatively unknown. Only painful conjunctivitis and palpebral odema are reported following venom sprayed or spat into the eyes Price's,[3] Rao[1] has reported bilateral blindness following snake bite in a person aged 46 years due to vitreous haemorrhage. But bilateral blindness due to optic neuritis has not been reported in the literatures. In this case the ophthalmoscopic picture was suggestive of post-neuritic optic atrophy. Modi[2] and Wright and Baird[4] are of the opinion that the snake venom of cobra produces neurotoxin which affects the nerves. In the presence of post-neuritic optic atrophy it is more plausable to rule out any cortical element producing this blindness.


  Summary Top


An interesting case of blindness is reported following snake bite.

 
  References Top

1.
B. Manohar Rao, 1977, Ind. Jour. of Ophthal. 25,11.  Back to cited text no. 1
    
2.
Modi's 1972, Test Book of Medical Jurisprudence and Toxicology. 612, N.M. Tripathy. Bombay.  Back to cited text no. 2
    
3.
Price's 1973, Text-Book of the Practice of Medicine. P. 305, Oxford publishers (Oxford University Press)  Back to cited text no. 3
    
4.
F.J. Wright and J.P. Baird 1972 Tropical disease, 111. The English language Book Society and Churchill Livingston.  Back to cited text no. 4
    




 

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