Title: A Rare Cause of Visual Loss Following Spider Bite
Authors: Ashok Jha, Alok Sati, Rishi Sharma
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.161
Abstract
A 25 year old male suddenly woke up early in the morning with pain following a spider bite on the left lower eyelid in desert area. Subsequently, he noticed swelling along with a dermonecrotic lesion on the left lower eyelid. His visual acuity was 20/20 in the right eye and absent light perception in the left eye. Relative afferent pupillary defect (RAPD) and retinal edema were present in left eye in addition to extinguished electroretinogram (ERG) and increased P100 latency on visual evoked potential (VEP). Inspite of administering intravenous methyl prednisolone and oral steroid, patient’s visual acuity persisted as absent light perception, and on follow up fundus showed optic atrophy and generalized constriction of vessels. Herein, for the first time, to the best of our knowledge, we are reporting a rare ocular manifestation following a spider bite, in form of unilateral neuroretinal involvement leading to complete loss of vision.
References
- Ghosh AK, Baqri QH, Prakash I (Eds.). 1996. Faunal diversity in the thar desert: Gaps in research. Scientific publishers, Jodhpur, India, 410pp.
- Sharma G, Kankane PL. 2012, Fauna of Ecosystems of India- Thar desert: 1-18. (Published by the director, ZSI, India)
- Sivaperuman C, Rathore Spiders in the Desert National Park. Faunal Ecology and Conservation of the Great Indian Desert. 2009, pp 49-52.
- Vetter RS, Visscher PK. Bites and stings of medically important venomous arthropods. Int J Dermatol 1998;37:481-96.
- Diaz JH, Leblanc KE. Common spider bites. Am Fam Physician 2007;75:869-73.
- Jarvis RM, Neufeld MV, Westfall CT. Brown recluse spider bite to the eyelid. Ophthalmology 2000;107:1492-96.
- Bilgili SG, Karadag AS, Karadag R, et al. A case of Spider bite localized to the eyelid.
- Cutaneous and Ocular Toxicology 2013; 32(1):83-5.
- Taşkesen M, Akdeniz S, Taş T, et al. A rare cause of severe periorbital edema and dermonecrotic ulcer of the eyelid in a child: Brown recluse spider bite. The Turkish Journal of Pediatrics 2011;53:87-90.
- Rekow MA, Civello DJ, Geren CR. Enzymatic and hemolytic properties of brown recluse spider (Loxosceles reclusa) toxin and extracts of venom apparatus, cephalothorax and abdomen. Toxicon 1983;21:441-44.
- Patel KD, Modur V, Zimmerman GA, et al. The necrotic venom of the brown recluse spider induces dysregulated endothelial cell-dependent neutrophil activation. Differential induction of GM-CSF, IL-8, and E-selectin expression. J Clin Invest 1994;94:631-42.
- Dyachenko P, Ziv M, Rozenman D. Epidemiological and clinical manifestations of patients hospitalized with brown recluse spider bite. J Eur Acad Dermatol Venereol 2006; 20:1121-25.
- Akdeniz S, Green JA, Stoecker WV, Gomez HF, et al. Diagnosis of loxoscelism in two Turkish patients confirmed with an enzyme-linked immunosorbenst assay (ELISA) and non-invasive tissue sampling. Dermatol Online J 2007;13:11.