Dr.SANTOSH VERMA, V20434
Aim: To report bilateral vitreous hemorrhage, an unusual presentation of snakebite.
Case history: Patient presented with bilateral loss of vision after snake bite. Blood investigation suggested severe anemia, normal renal function but deranged liver function. On ocular examination vision of RE was HMCF and LE PL+. Pupillary reaction was sluggish. IOP was normal. Slit lamp bio-microscopy & dilated fundus ophthalmoscopy revealed hazy vitreous, suggestive of vitreous hemorrhage. On fundus photography, media was too hazy to comment posterior segment. Ocular USG B-scan confirmed vitreous hemorrhage. VEP study showed absence of P100 waveform in recordings. MRI brain revealed collections in bilateral posterior chamber and subretinal regions. Patient was advised bed rest, oral vitamin-C tablets, oral steroids and elective vitrectomy.
Conclusion: Vitreous hemorrhage should be suspected in cases of deterioration of vision after snake bite even if no other signs of hemorrhages are present.
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