Ocular Monkeypox - United States, July-September 2022

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• Monkeypox virus (MPXV) can cause ocular complications, including conjunctivitis, keratitis, and vision loss, particularly through autoinoculation.
• Ocular involvement in monkeypox, though rare, presents a significant risk for visual impairment.

Purpose of the Study:

• To describe cases of ocular monkeypox and highlight the importance of prompt diagnosis and treatment.
• To inform healthcare providers about the potential for sight-threatening ocular complications from monkeypox.

Main Methods:

• Retrospective case series of five patients with ocular monkeypox reported between July-September 2022.
• Review of clinical presentations, treatments (tecovirimat, trifluridine), and outcomes, including hospitalization and vision impairment.

Main Results:

• Four of five patients were hospitalized, and one experienced significant vision impairment.
• Two immunocompromised patients (HIV-associated) had delayed treatment initiation.
• All patients received tecovirimat, with four also receiving topical trifluridine.

Conclusions:

• Ocular monkeypox is a serious condition requiring urgent ophthalmologic evaluation and prompt antiviral treatment.
• Preventive measures, including hand hygiene and avoiding eye contact, are essential to reduce autoinoculation risk.
• Increased clinician awareness and prompt public health notification are vital to mitigate morbidity associated with ocular monkeypox.