Diagnosis and management of palpebral anthrax

Anthrax is an infectious disease that is not well known by ophthalmologists. In its cutaneous form, it may produce lesions of the eyelids. We report eight cases of palpebral anthrax. All patients presented with a black necrotic eschar and a tegumentary edema, with a history of contact with sick animals. The curative treatment was based on intravenous penicillin G in four cases and amoxicillin-clavulanic acid in the four other cases. The palpebral lesions resolved, leaving no clinical evidence of eyelid abnormalities in six patients. Only two patients developed a cicatricial ectropion and a palpebral symphysis. Although palpebral anthrax is a rare disease in humans, ophthalmologists should be aware of its symptoms and management.