One
week to 10 days after implantation, a central, grayish, disciform
corneal lesion can be seen. (Often there are accompanying
or preceding palpebral or peri-orbital vaccinations). With
periorbital or mucosal involvement there may be considerable
pruritus, leading to further rubbing of the eye and continued
spread of the virus.
Slit-lamp examination is best for defining the early stages,
as well as following the course of disease and response to
treatment. As the infection progresses a deeper ring-like
lesion appears in the cornea. There may be uveal involvement
and Descemetís membrane may be infected. In some instances,
more distal parts of the cornea may be involved. The corneal
lesions appear crater-like and are indurated, edematous and
infiltrated.
A late manifestation, occurring as a result of natural healing,
or because of the administration of VIG (which is contraindicated),
is extensive cloudiness in the region of the original lesion.
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