Anticholinesterase Treatment for Patients With Paralytic Strabismus Following a Viper Bite.

Lee, Jung Ho; Ahn, Sung Min; Jung, Bo Young

doi:2009.50.11.1698

J Korean Ophthalmol Soc > Volume 50(11); 2009 > Article

Original Article

Journal of the Korean Ophthalmological Society 2009;50(11):1698-1704.
DOI: https://doi.org/10.3341/jkos.2009.50.11.1698 Published online November 15, 2009.

Anticholinesterase Treatment for Patients With Paralytic Strabismus Following a Viper Bite.

Jung Ho Lee, Sung Min Ahn, Bo Young Jung

Department of Ophthalmology, Dongguk University Gyeongju Hospital, Gyeongju, Korea. letter0116@naver.com

독사 교상 후 마비사시를 보이는 환자에서 항콜린에스테라제의 치료

이중호ㆍ안성민ㆍ정보영

Department of Ophthalmology, Dongguk University Gyeongju Hospital, Gyeongju, Korea

Abstract

PURPOSE
To describe the therapeutic effect of anticholinesterase treatment for patients with paralytic strabismus and blepharoptosis following a viper bite METHODS: A prospective non-comparative interventional case series study was designed including 6 patients with ophthalmic complications such as paralytic strabismus and blepharoptosis following a viper bite. Anticholinesterase (pyridostigmine) 60 mg was administered to patients 3 times a day in additional to conservative treatment including antivenom, antibiotics and tetanus toxoid. Patients underwent a measurement of deviation, diplopia test and MRD 1. Subjective evaluation of the diplopia symptoms was performed daily after treatment. RESULTS: Subjective diplopia was relieved in 2 out of the 6 patients on the first day and in the other 4 patients on the second day. The angle of deviation decreased approximately 37% on the first day and ocular position became orthophoric on the third day in all patients. The blepharoptosis was completely resolved in 4 patients on the first day. No complication following anticholinesterase treatment was noticed. CONCLUSIONS: Treatment using anticholinesterase for patients suffering from diplopia and blepharoptosis following a viper bite is an effective and safe treatment.

Key Words: Anticholinesterase;Blepharoptosis;Paralytic strabismus;Snake bite