Monkeypox Related Keratitis: Case Series

Monkeypox-Associated Keratitis: A Novel Case Series with Clinical Implications

To describe the clinical characteristics, diagnostic approach, and therapeutic management of monkeypox-associated keratitis through a series of cases documented during the 2022-2023 global outbreak, contributing to the limited existing literature on ocular manifestations of this emerging viral infection.

A retrospective analysis of two laboratory-confirmed cases of monkeypox-associated keratitis presenting to a tertiary eye care center. Both cases underwent comprehensive ophthalmic examination, PCR viral testing, photographic documentation, and standardized treatment protocols with careful monitoring of treatment response and outcomes.

Case 1 involved a young adult female who developed a characteristic ring-shaped corneal infiltrate following a systemic monkeypox infection with cutaneous manifestations. Case 2 presented in a pediatric patient who initially manifested with viral conjunctivitis concurrent with systemic rash, subsequently progressing to ring-shaped corneal infiltration. Both cases were confirmed through PCR testing and demonstrated favorable response to antiviral therapy, with complete resolution of corneal inflammation and preservation of vision. The distinctive ring-shaped infiltration pattern observed in both cases may represent a characteristic finding of monkeypox-associated keratitis.

This case series highlights monkeypox-associated keratitis as a rare but vision-threatening ocular complication requiring prompt recognition and intervention. The consistent finding of ring-shaped corneal infiltrates may serve as a key diagnostic feature. Our experience demonstrates that early diagnosis through PCR testing and prompt initiation of antiviral therapy can lead to favorable outcomes. These findings have important implications for ophthalmologists and healthcare providers managing patients with monkeypox infection.