Santanu Sinha Babu, Md. Nazarul Islam, Prasenjit Maiti
BACKGROUND Snake bite is a common and dangerous public health problem. It evokes primordial fear in human beings. Still the public health importance of snake bite has widely been neglected. Though ophthalmological manifestations are uncommon, there are very few community-based surveys on ocular manifestations related to haemotoxic snake bite in West Bengal. We wanted to assess the prevalence and pattern of ocular morbidity due to haemotoxic snakebite among the patients in a tertiary care hospital and evaluate the causes of vision loss following haemotoxic snakebite in rural West Bengal. METHODS One hundred and ten patients (n=110) of haemotoxic snake bite cases admitted at R G Kar Medical College have been studied between February 2018 to January 2019. All the admitted patients were initially managed in the Medicine department and ocular examination was done after stabilization of the patients. This is a cross sectional observational study. RESULTS Males were the most common victims. Sub conjunctival haemorrhage (10%) followed by acute anterior uveitis (7%) was the most common anterior segment finding. Cotton wool spots and retinal haemorrhage were the most common posterior segment findings. Other findings were chemosis, episcleritis, scleritis, eyelid swelling, keratomalacia, endophthalmitis and angle closure glaucoma. Other findings were vitritis, vitreous haemorrhage, macular infarction, central retinal artery occlusion, exudative retinal detachment and optic disc swelling. One case of direct ocular injury was seen from ocular bite resulting in conjunctival and corneal laceration. CONCLUSIONS It is very essential to limit the vision loss and minimize the ocular side effects especially in rural hospital. It is very challenging and special training to ophthalmologist at primary level may be necessary for diagnosis and management of such type of cases.
