Ashes to eye: A skilled snake handler's experience with ophthalmic envenomation

Abstract

With the continued growth of human populations, rural urbanisation and habitat degradation are on the rise, resulting in the displacement of native wildlife and an increase in human-wildlife conflicts. The presence of human habitation and waste often attracts rodents and thereby, snakes, leading to increased snake sightings in homes. To address this problem, snake handlers, who are volunteers that remove and relocate snakes away from human development areas, are called upon. However, snake removal is a high-risk task that poses a risk of envenomation, particularly when dealing with spitting snakes. Several cobra species have the ability to spit venom. If the venom enters a person's eye, it can result in ophthalmic envenomation, which can have serious consequences for their eyesight. Therefore, snake handlers should take precautions, wear suitable eye protection, and use appropriate tools to ensure their safety and that of the snake. In this case, an experienced snake handler was called to remove a spitting cobra, but they were ill-equipped. During the removal, the venom was sprayed across the handler's face, and some of it entered their eye, resulting in ophthalmic envenomation. The handler promptly irrigated their eye, but medical treatment was still necessary. This report highlights the risks and consequences of ophthalmic injury and the importance of wearing appropriate eye protection and taking due care when dealing with venomous species, particularly those that can spit venom. It serves as a reminder that accidents can happen at any time and experienced snake handlers are not exempt from the risks.

Fig 1. A snake handler suffers ophthalmic envenomation by an Ashe’s spitting cobra.

(A) the offending snake was identified as an Ashe’s spitting cobra (Naja ashei) by a trained herpetologist and the snake handler. (B) the eye of the victim after the ophthalmic envenomation occurred, highlighting the irritation of the eye. (C) the affected eye of the victim the morning after the incident occurred, highlighting the thick mucus build-up. (D) the affected eye at 2 pm on the day after the incident occurred, following Diclogenta treatment.

Fig 2. Symptoms and main events with appropriate timelines illustrating the impact and recovery following the ophthalmic envenoming by an Ashes spitting cobra.