Vaccination of the Cornea

Story, John B.

doi:10.1136/bmj.1.2406.346-c

Cited by 5 publications

(2 citation statements)

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“…59 Vaccinia pustules may occur on the conjunctiva, either through direct inoculation or spread from an eyelid lesion. 52,53,55,60 Corneal ulceration may arise in a clear cornea or adjacent to a conjunctival pustule 51,[61][62][63][64][65][66][67][68] and can result in perforation 61,63 and hypopyon. 61 Disciform keratitis may occur as late as 2 to 3 months after immunization.…”

Section: Ocular Complications Of Smallpox Immunization Clinical Findingsmentioning

confidence: 99%

“…52,53,55,60 Corneal ulceration may arise in a clear cornea or adjacent to a conjunctival pustule 51,[61][62][63][64][65][66][67][68] and can result in perforation 61,63 and hypopyon. 61 Disciform keratitis may occur as late as 2 to 3 months after immunization. 67,[69][70][71][72][73] Other complications include interstitial keratitis with vestibuloauditory symptoms, 74 iritis, 23,75 central retinal artery occlusion, 76 pigmentary retinopathy, 77,78 chorioretinitis, 74,79 central serous retinopathy, 74 exudative retinitis, 80 optic neuritis, 79,[81][82][83] retrobulbar neuritis with encephalomyelitis, 84 transient strabismus, 85 and orbital involvement with proptosis, reduced ocular motility, and optic atrophy.…”

Section: Ocular Complications Of Smallpox Immunization Clinical Findingsmentioning

confidence: 99%

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The Ocular Complications of Smallpox and Smallpox Immunization

Semba¹

2003

Arch Ophthalmol

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lthough smallpox was eradicated worldwide, concerns have been raised about the use of smallpox as a biological weapon. Plans are being considered for smallpox immunization in the United States. Variola virus, the cause of smallpox, and vaccinia virus, used in smallpox immunization, are both orthopoxviruses that are associated with serious ocular complications, including eyelid and conjunctival infection, corneal ulceration, disciform keratitis, iritis, optic neuritis, and blindness. About 5% to 9% of patients with smallpox develop ocular complications, and case-fatality rates reach 20% to 35% among unvaccinated individuals. About 10 to 20 patients develop ocular complications per 1 million smallpox immunizations, usually through autoinoculation, in which the patient transfers vaccinia from the immunization site to the eye. The risk of ocular vaccinia infection may be reduced by instructing patients and individuals in close contact with the vaccinee to wash their hands often and avoid touching the immunization site and their eyes. Topical antiviral therapy, topical steroids, and topical and oral antibiotics have been used to reduce the ocular complications of smallpox immunization. In contrast, there has been little experience with the use of these therapies for the ocular complications of smallpox.

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