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).