Investigators Suggest Conjunctivitis May Transmit Monkeypox

Fernando Ly-Yang, MD, and investigators from the Ophthalmology Service, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos in Madrid, Spain, found that conjunctivitis may be associated with monkeypox, after observing that a man, aged 42 years, who had monkeypox also had conjunctivitis and HIV. The research team suggests that patients who are immunocompromised with HIV may be more likely to have conjunctival inflammation from monkeypox.

The patient’s eye had conjunctival lesions and thickening, mucoid discharge, and ulcerations on the margins of his eyelid. He also experienced photophobia in his left eye.

The patient was treated with intravenous acyclovir 1 g every 8 hours, tecovirimat 600 mg every 12 hours, and topical zinc (for skin lesions) every 8 hours. His topical conjunctivitis treatment regime included chlorhexidine 0.2%, ganciclovir 0.15%, povidone-iodine 1%, and moxifloxacin drops 5 times per day.

The investigators said 23% of monkeypox cases result in conjunctivitis, although these cases generally happen in boys younger than 10 years. Monkeypox is not confirmed to spread through tears during conjunctivitis, but smallpox is. Investigators noted that the similarity between the 2 diseases might indicate that conjunctivitis can spread monkeypox.