Snakebite hemotoxin-induced unilateral retinopathy: Case report and review of the literature

Abstract

Ocular manifestations of snakebite depend on the nature of envenomation. Neurotoxic venoms usually cause neurological manifestations such as ptosis and external ophthalmoplegia, whereas hemotoxic poisons cause hemorrhagic manifestations such as hemorrhagic retinopathy and arterial occlusions. However, most of the ocular manifestations present bilaterally. We report a unique case of a female in her 5th decade presenting with unilateral snakebite hemotoxin-induced retinopathy in the form of subretinal and preretinal hemorrhages presenting 5 days after the snakebite. She was managed conservatively. Preretinal and subfoveal bleed gradually resolved with fair visual recovery. Anatomical differences in the vasculature between the two eyes along with some degree of venous occlusion in the left eye might have contributed to such an asymmetrical presentation.