Abstract

A 39-year-old man consulted for unilateral red eye and itchiness (Fig A, C) 5 days after positive monkeypox virus (MPOX) cutaneous polymerase chain reaction (PCR) swab from chin and lip lesions (Fig B). Slit-lap examination showed conjunctival follicular reaction and the presence of small white vesicles on the nasal bulbar conjunctiva (Fig C, arrow). The rest of the anterior and posterior segment were normal, and the fellow eye remained uninvolved during follow up. Two separate conjunctival PCR swabs were positive for MPOX, confirming indirectly similar loads of the virus on conjunctival and eye secretions compared with cutaneous lesions (26.7 vs 24.8 [cycle threshold] respectively), raising the possibility of transmission via eye contact, i.e., during ophthalmologic examination.

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