Chronic endothelial changes secondary to snake envenomation

This case report describes the ocular findings in a 45-year-old female who presented to us after 7 months of snakebite. Ocular examination revealed bilateral asymmetric chronic anterior segment ischemia mimicking uveitis in both eyes. Central corneal thickness was increased in the left eye. Specular microscopy of both eyes revealed a reduced endothelial cell density, pleomorphism, and polymegethism. These findings suggest that anterior segment ischemia and corneal endothelial changes may occur as delayed sequelae of snake envenomation or anti-snake venom administration. Recognition of these manifestations is important, as they may mimic chronic uveitis and have implications for long-term visual prognosis.