There are significant knowledge gaps regarding the burden and clinical progression of ocular manifestations of mpox in Nigeria and worldwide. Here, we report two laboratory-confirmed mpox cases in young male adults with different presentations of ocular mpox at two tertiary hospitals in southern Nigeria during the 2022/2024 global outbreak. The first patient, a 28-year-old man, presented at the Alex Ekwueme Federal University Teaching Hospital in Abakaliki with a vesiculopustular rash on his nasal bridge and right lower eyelid, along with redness, pain, and itching. He later developed corneal ulcers and vision problems during follow-up after discharge. The second case involved a 44-year-old man with advanced, treatment-naive HIV infection. He presented with widespread vesiculo-pustular skin eruptions, including characteristic rashes around the periorbital and orbital areas. His condition rapidly worsened, leading to his death after seven days of hospitalisation. Consistent with guidance from the Nigeria Center for Disease Control and Prevention, lesional skin swabs from both patients were sent to the National Reference Laboratory in Abuja for quantitative polymerase chain reaction (qPCR), which tested positive for the monkeypox virus. Supportive care included antibiotics, fluids, nutritional support, and skin care, as no specific mpox treatments were available at that time. A multidisciplinary team, without an ophthalmologist, managed the care. Ocular mpox has been increasingly reported since the 2022 global outbreak. Continued surveillance and research are vital for monitoring mpox´s evolving epidemiology, understanding eye-related diseases and potential complications, and improving prevention and treatment strategies for both systemic and ocular symptoms to prevent severe vision loss and enhance overall patient outcomes.

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Corresponding author
Chizaram Anselm Onyeaghala, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria (Chizaram.onyeaghala@npmcn.edu.ng)