Vaccinia of the eyelids, although not a rare condition, is uncommon and may cause serious ocular complications. Contact infection from others with vaccinia is probably commoner than autoinoculation. In about one third of the cases, the cornea becomes involved, and vaccinial diskiform keratitis and necrosis may result in loss of the eye. Untreated vaccinia usually runs a course of 28 to 31 days. Crusting may appear after the 12th day, followed by a varying period of ulceration. When large areas of the lid margins are involved, thickening may persist for several months and gradually disappear or may be followed by permanent distortion or symblepharon. The infection may spread to the other eye, and necrosis may follow secondary infection.
Treatment in the past has been concerned chiefly with the symptoms, maintenance of sanitary conditions, and application of various antiseptic solutions locally. Atkinson and Scullard advised therapeutic measures aimed specifically against the
King JH, Forrest RL. VACCINIA OF THE EYELIDSTREATMENT BY AUREOMYCIN IN A SECOND CASE. JAMA. 1953;153(1):31–32. doi:10.1001/jama.1953.02940180033010b
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