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Vaccinia keratitis - Smallpox Vaccination
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Vaccinia keratitis - Smallpox Vaccination

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Contributors: Art Papier MD, Vince Fulginiti MD
Other Resources UpToDate PubMed

Synopsis

Vaccinia keratitis, although rare (and severe if left untreated), occurs when vaccinia virus is accidentally implanted into the periorbital structures or the cornea. Viral replication and the immune response lead to ulceration with subsequent corneal scarring or clouding. Lesions of the cornea secondary to implantation are potentially threatening to eyesight.

Although individuals with healthy eyes are susceptible to vaccinia keratitis, those with pre-existing eye disease (especially inflammatory diseases of the lids, conjunctiva and cornea) are particularly prone to implantation from contact with contaminated hands. Caretakers who bathe or otherwise handle children with vaccinations are the most likely to experience accidental transfer.

To prevent vaccinia keratitis, avoid vaccinating individuals with inflammatory eye or periorbital disease and instruct vaccinees and close physical contacts (eg, household members) of vaccinees to avoid touching, rubbing or otherwise performing any maneuvers that might transfer vaccinia virus from a vaccination site to the eye or surrounding skin.

Codes

ICD10CM:
H16.8 – Other keratitis

SNOMEDCT:
397552005 – Vaccinia keratitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Herpes virus keratitis
Herpes zoster ophthalmicus

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 03/20/2013
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Vaccinia keratitis - Smallpox Vaccination
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Vaccinia keratitis : Eye, Eyelid edema, Eyelids, Conjunctival injection, Ocular pruritus
Clinical image of Vaccinia keratitis
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