Venom ophthalmia from a spitting Samar cobra (Naja samarensis): A case of corneal injury

Snake venom ophthalmia is a potentially blinding condition requiring prompt management. This case presents the first detailed ophthalmologic examination of Samar cobra (Naja samarensis) venom ophthalmia, an endemic Philippine species. A 47-year-old Filipino male reported immediate burning sensation and eye irritation after being spat on while clearing debris under his home. Clinical examination revealed conjunctival hyperemia and right eye swelling. The patient received immediate irrigation with Lactated Ringer's solution through a Morgan lens, followed by topical antibiotics. Slit lamp examination confirmed punctate epithelial erosions on the cornea, documenting corneal injury specific to this species. The patient recovered completely within five days with appropriate medical management. While recent literature reports corneal complications in Asian cobra ophthalmia, this case provides the first corneal documentation in N. samarensis envenomation. Our findings contribute valuable clinical evidence for managing this endemic Philippine species and emphasize the importance of routine ophthalmologic evaluation in spitting cobra exposures.