Discussion
Snakebite can present with a myriad of local and systemic complications
depending on the nature of the toxin injected and can be either
hematological or neurological. The toxins and enzymes in the venom
include hydrolase, arginine, and esterase which leads to
hypercoagulation added upon by hypovolemia, toxic vasculitis, and
consumption coagulopathy (DIC) [2]. Any inherent deficiency of
protein C, protein S, and antithrombin III can manifest as excessive
bleeding. Viperidae snake venom contains hemorrhagins which may result
in severe vascular spasm, endothelial damage, and increased vascular
permeability via complement-mediated activation, leading to vascular
occlusions throughout the body [4], [5]. Ocular disturbances
resulting from snakebite, are rare and can range from, subconjunctival
hemorrhage, hyphema, ptosis, ophthalmoplegia, keratomalacia, uveitis,
central retinal artery occlusion, optic neuritis, macular infarction,
vitreous hemorrhages, tractional retinal detachment, globe necrosis to
cortical infarction [2], [3], [4]. Our patient is the first
reported case of an isolated unilateral subhyaloid hemorrhage following
a snake bite. Spontaneous reabsorption of the hemorrhage may occur in
1–2 months, but during this time the dispersion of this blood leads to
hazy vitreous, formation of preretinal tractional membrane, and
proliferative vitreoretinopathy which may irreversibly damage the retina
and cause permanent visual loss, hence laser photocoagulation or a laser
hyaloidotomy can be done, as done in the index case [6], [7].