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Abstract
*Correspondence, Alfonso Vasquez-Perez: alest99@gmail.com
Importance Ophthalmic manifestations occur in less than 5% of cases in human monkeypox, most commonly presenting with self-limiting conjunctivitis and keratitis. We herein present a case of severe ophthalmic complication.
Objective To present a case of human monkeypox with sight threatening necrotising blepharoconjunctivitis.
Method This is a report of a patient who developed necrotising conjunctivitis due to monkeypox at a large University hospital.
Main Outcome and Measures Description of the progression and clinical evaluation of the ocular condition and the management.
Results A 63-year-old male HIV positive presented initially with conjunctivitis and eyelid swelling and developed skin lesions from monkeypox virus two days later. Despite remaining stable systemically, after four days his ophthalmic condition evolves to necrotising blepharoconjunctivitis for which systemic antiviral treatment with tecovirimat was given along with topical trifluoridine 1% eye drops. In addition, he required repeated tissue debridement with amniotic membrane grafting to preserve the eye integrity.
Conclusions The severity of our observation was associated with a co-existing immunocompromised state and appeared similar to findings associated with other orthopoxviruses. Ophthalmic manifestations could be the initial presentation of human monkeypox and could also be severe. Early recognition and intervention may limit the likelihood of substantial ocular morbidity.
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