Letter to the Editor| Volume 39, ISSUE 5, P660-661, November 2010

Response to Drs. Chu, White, and Weinstein

Published:November 18, 2009DOI:
      I appreciate Drs. Chu, White, and Weinstein's interest in my article, “Ophthalmic Exposure to Crotalid Venom” (
      • Johnson R.
      Ophthalmic exposure to crotalid venom.
      ). Their comments are not only complete but also give a brief overview of the treatment of crotalid envenomation and describe what is thought to be the standard of care for crotalid ocular envenomations.
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        • Johnson R.
        Ophthalmic exposure to crotalid venom.
        J Emerg Med. 2009; 36: 37-38
      1. Hayes A.W. Principles and methods of toxicology. 5th edn. Oehme and Keyler, New York, NY2008

      Linked Article

      • Ophthalmic Exposure to Crotalid Venom
        Journal of Emergency MedicineVol. 36Issue 1
        • Preview
          Crotalid venom exposure to the eye is uncommon. A 40-year-old woman sustained an accidental mucus membrane exposure of rattlesnake venom to her face and right eye. She was successfully treated with irrigation, topical antibiotics, and intravenous crotalid antivenin.
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      • Is There Any Role for Intravenous Antivenom for Snake Venom Ophthalmia?
        Journal of Emergency MedicineVol. 39Issue 5
        • Preview
          We read with interest the article entitled “Ophthalmic Exposure to Crotalid Venom,” which presented the first reported case involving the use of intravenous (i.v.) antivenom (CroFab®; BTG International Inc., West Conshohocken, PA) in the management of pit viper ocular accidental contact irritation (1). Virtually all published experience with snake venom ophthalmia relates to spitting cobras (family Elapidae), where both fangs and venom have evolved to specifically target the eye, yet there is no evidence that this results in systemic envenoming, the prime indication for antivenom therapy.
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