Anterior Segment Ischemia in Viper Bite

Abstract

Purpose: To describe the clinical and histopathological features of post viper bite anterior segment ischemia.

Methods: Seven patients with ocular complications following viper bite referred to uveitis clinic had slit-lamp examination, intraocular pressure (IOP) measurement, and fundus evaluation. Iris and fundus fluorescein angiography was performed on 2 patients. Histopathological examination was performed on iris tissues collected during cataract surgery.

Results: Strikingly similar clinical findings were noted, including circumpupillary superficial iris atrophy, mid dilated fixed pupil, marked pigment dispersion, low IOP, and cataract. All clinical signs were noted only in the anterior segment; the posterior segment was normal. Histopathology of iris revealed atrophy of iris stroma, necrotic iris pigment epithelium, and infiltration of T lymphocytes and fibrous membrane. Poor visual outcome was noted in patients with low IOP.

Conclusion: Viper bite victims presented with clinical and histopathological signs of anterior segment ischemia and secondary inflammatory signs mimicking uveitis.

• Anterior segment ischemia
• cholinergic vasoconstriction
• iris atrophy
• uveitis masquerade
• viper bite

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This study was supported by the Aravind Medical Research Foundation & Department of Ophthalmology, University of Southern California.

The authors have no proprietary or commercial interest in any materials discussed in this article.