Bilateral optic neuropathy following bite from brown recluse spider (Loxosceles reclusa)

Abstract

A 63-year-old female with history of a resected frontal lobe meningioma presented with bilaterally decreased vision after a bite from a brown recluse spider. The exam was significant for a left relative afferent pupillary defect, bilateral optic nerve pallor, decreased foveal sensitivity in the left eye and new bilateral visual field defects, despite stability of her meningioma. The findings remained stable at 1-year follow-up. To our knowledge, this is the first reported case of optic neuropathy secondary to a brown recluse spider bite. Visual field tests performed prior to the bite allowed us to compare and localize changes related to the bite.

• Brown recluse spider
• envenomation
• Loxosceles reclusa
• optic neuropathy
• spider bite
• toxic

Declaration of interest

Supported by the National Eye Institute of the National Institutes of Health under Award Number K08EY022672 (This article does not necessarily reflect the views of the National Institute of Health). Additional funds were provided by the Ohio Lions Eye Research Foundation, Fund No. 313310 in Ophthalmology.