Cobra venom keratoconjunctivitis.

We present a case of cobra venom keratoconjunctivitis, an ocular injury caused by a snake's defensive mechanism of spitting venom into a predator's eyes. A male in his 50s reported to the outpatient department of a regional hospital in Songea, Tanzania, with 24 hours of eye pain, photophobia and decreased vision after being sprayed in the face by a cobra. The affected eye was anaesthetised with topical tetracaine hydrochloride 0.5% and irrigated with 1 L of lactated Ringer's solution. Tetracycline hydrochloride 1% ophthalmic ointment was placed in the inferior sulcus, and the lid was taped shut for 24 hours. The patient was instructed to apply the antibiotic ointment two times per day and to follow-up in 48 hours. At the follow-up visit, the patient reported a reduction in pain within 24 hours. Although his vision remained blurry, the pain had diminished. Several weeks later, the patient's vision had returned to baseline.