Acute angle closure glaucoma with capilllary leak syndrome following snake bite

Abstract

Acute angle closure glaucoma is rarely seen as complication of snake bite.We report three cases of bilateral acute angle closure glaucoma with capillary leak syndrome and acute renal failure secondary to hematotoxic snake bites. We are also briefly discussing the association of capillary leak syndrome and angle closure glaucoma in hematotoxic snake bite. This is the first time an association between angle closure and capillary leak syndrome following snake bite is reported. Study type: Descriptive case series. Materials and Methods: Records of all patients admitted to ICU with snake bite were reviewed to identify cases developing acute angle closure glaucoma. These cases with acute angle closure glaucoma are analysed in detail for systemic condition. Diagnosis, management and outcome of cases are described. Results: Of the 119 snake bites admitted, 47 patients had confirmed hematotoxic snake bite. 15 of these patients underwent hemodialysis for acute renal failure. 7 of them were diagnosed to have capillary leak syndrome and all of them complained of decreased vision. 3 of the 7 cases had acute angle closure glaucoma on the second day of bite. One of the patients expired and other two recovered fully, both of them had normal IOP and good vision at one month follow up. Conclusion: Acute angle closure glaucoma seems to be associated with systemic capillary leak syndrome in hematotoxic snake bite. High suspicion, early recognition, timely and appropriate treatment can prevent visual loss in this rare complication.