Case Report / Examination
A 32-year-old male patient presented to the outpatient clinic with the
complaint of sudden onset, painless, non-progressive diminution of
vision in the left eye following an unknown snake bite, six days ago. He
was managed primarily at a primary health care centre, where supportive
medical treatment and anti-snake venom were given.
At the time of presentation, he was conscious, oriented, with stable
vitals and unremarkable systemic examination. His detailed past medical
history revealed no co-morbidities or systemic illnesses. On ocular
examination, his best corrected visual acuity was 6/6 in the right eye
(RE) and finger counting up to one meter in the left eye (LE), with the
perception of rays accurate in all quadrants. Pupillary reflex both
direct and consensual were normal (OD and OS) in both eyes. Slit lamp
biomicroscopy revealed a clear cornea, quiet anterior chamber, and clear
lens with intraocular pressure of 14mmHg (on Rebound tonometry) in both
eyes. Fundus examination of the RE was normal and LE showed the presence
of a single sharply demarcated boat-shaped subhyaloid hemorrhage,
occupying the lower half of the posterior pole including the macula
(Figure 1).