Visual loss with inner retinal dysfunction, after snake bite: two case reports

Purpose To report two cases of visual loss following snake bite. Method Retrospective review of medical records including history, examination finding, fundus details and investigation reports (visual field, electroretinogram, visual evoked potential and optical coherence tomogram) at two centers. R...

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Bibliographic Details
Published in:Documenta ophthalmologica 2013-10, Vol.127 (2), p.155-163
Main Authors: Jalali, Subhadra, Padhi, Tapas Ranjan, Bansal, Reema, Sahoo, Kalyani, Basu, Soumavaya, Mathai, Annie
Format: Article
Language:English
Subjects:
Adult
Blindness - etiology
Blindness - physiopathology
Clinical Case Report
Electroretinography
Evoked Potentials, Visual - physiology
Fluorescein Angiography
Humans
Male
Medicine
Medicine & Public Health
Ophthalmology
Optic Atrophy - etiology
Optic Atrophy - physiopathology
Retinal Artery Occlusion - etiology
Retinal Artery Occlusion - physiopathology
Retinal Diseases - etiology
Retinal Diseases - physiopathology
Retinal Neurons - physiology
Retrospective Studies
Snake Bites - etiology
Snake Bites - physiopathology
Tomography, Optical Coherence
Visual Acuity - physiology
Visual Field Tests
Visual Fields
Young Adult
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Summary:Purpose To report two cases of visual loss following snake bite. Method Retrospective review of medical records including history, examination finding, fundus details and investigation reports (visual field, electroretinogram, visual evoked potential and optical coherence tomogram) at two centers. Result Two cases of snake bite presented to us with reduction of vision at 1 and 3 months after the incident. The subnormal b wave and abnormal pattern electroretinography in one case pointed at inner retinal dysfunction and neurotoxicity as the cause of visual loss in an apparently normal-looking fundus. The electronegative b wave in the other gave us a clue that the optic atrophy was consecutive (secondary to inner retinal dysfunction due to central retinal artery occlusion). Conclusion When presented late, diagnosis of visual loss secondary to snake bite becomes difficult and puzzling due to the absence of classical findings. Electrophysiological tests in such cases give us important clue to reach at a definite diagnosis.
ISSN:0012-4486
1573-2622
DOI:10.1007/s10633-013-9390-1