…Africa unwrapped

Ashe’s spitting Cobra – kilome © MuokiKioko’22

Article by Stephen Sprawls

This is what we wrote in ‘Danerous Snakes of Africa’; Spitting snakes; first aid for venom in the eyes

The most effective treatment, if a spitting cobra has spat venom into someone’s eye, is to wash the eye gently with large quantities of water, this will remove residual venom. Stay calm while organising this; the victim isn’t going to die, and the eyes are essential organs; treatment must be gentle and careful. Better to take a little longer to organise a bucket and some help, rather than quickly squirting a hose in someone’s eyes, you don’t want to cause further damage. The easiest way to wash out the eye, if the victim can stand, is to hold the eye under a gently flowing tap, rotate the eye and move the head around, while holding the eyelid open, so water enters from all directions and reaches all parts of the eyeball. Alternatively, get the victim to put his/her face under water in a big bowl or sink (if there is venom in both eyes, this is the best method) and then hold the eyes open and rotate them, and blink vigorously. If the victim is in severe pain and can’t control themselves, lay them down on their back and get someone to hold them while someone else gently pours (not squirts) water into the eyes. Treatment should be started as soon as possible after the accident, but will be beneficial even if started many hours later; and should be continued for at least 20 minutes. In the absence of water, fluids such as beer, soft drinks, cold tea, saliva or even urine can be used, and milk is very suitable and soothing. But never use potassium permanganate solution or petrol, which could damage the eye.

It may be helpful to thoroughly wash down the face, neck and hands, while the victim keeps their eyes closed, in case any venom is still present and then gets accidentally wiped into the eye (although venom on unbroken skin is not harmful, nor is venom in the mouth, provided it is spat out promptly). Anaesthetic eye drops would be most useful for the pain, but the victim will find it difficult not to rub the eye, and if it is anaesthetised, much damage could be done, so keep the victims’ hands away from their eyes. Put a soft cotton wool pad and a soft bandage over the eye, or wear a pair of very dark glasses. Analgesic drugs can be taken. Venom in the eye is not life-threatening, merely very painful, and there is no need to inject serum or put it in the eye. However, the victim should visit an eye clinic or a hospital, where slit lamp microscopy and/or fluorescein staining may be undertaken to see if there is any corneal damage. Such damage often occurs and until the cornea regenerates, it is prone to secondary bacterial infection. Always, if possible, use an antibiotic eye ointment for prophylaxis.