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The ocular complications of smallpox and smallpox immunization
1Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. rdsemba@jhmi.edu
Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 14, 2003
Summary
Concerns about smallpox as a biological weapon are leading to immunization plans. Ocular complications from smallpox and vaccinia virus immunization can be serious, but hygiene and prompt treatment can mitigate risks.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Smallpox, though eradicated, is a bioterrorism concern.
- Smallpox immunization is being considered in the US.
- Orthopoxviruses (variola and vaccinia) cause severe ocular complications.
Purpose of the Study:
- To review ocular complications of smallpox and vaccinia immunization.
- To discuss risk reduction and treatment strategies for ocular vaccinia.
Main Methods:
- Literature review of ocular complications associated with smallpox and vaccinia.
- Analysis of incidence and risk factors for ocular vaccinia.
- Summary of therapeutic interventions.
Main Results:
- 5-9% of smallpox patients experience ocular complications.
- Ocular complications occur in 10-20 per million immunizations, often via autoinoculation.
- Case-fatality rates for smallpox reach 20-35% in unvaccinated individuals.
Conclusions:
- Good hygiene practices can reduce the risk of ocular vaccinia.
- Topical antivirals, steroids, and antibiotics show promise in managing ocular complications.
- Further research is needed on treating ocular complications from smallpox.