Acute Angle Closure Following a Snake Bite: Are We Missing It?

Angle-closure glaucoma following a snake bite is a rarely reported occurrence. Snake venom is a complex heterogeneous compound that can cause various systemic effects including ocular complications. These can result from direct exposure of the eye to the toxin or through the toxin in the blood. There can be varied ocular presentations, and this is a potentially blinding condition that is often ignored in the context of acute snake envenomation which often presents with life-threatening complications. Angle-closure glaucoma is reported to occur in about 50% of cases that have ocular involvement. Ciliary body edema due to generalized capillary leakage, idiosyncratic reaction to anti-snake venom, ghost cell glaucoma, angle closure secondary to uveitis, ocular ischemia, and cataract are some of the postulated mechanisms causing this ocular problem. Timely recognition of this condition in an intensive care setting will enable adequate treatment and a favorable prognosis.