Ocular and Periorbital Manifestations of Molluscum Contagiosum: A 20-year Systematic Review.

Objective: The goal of this study was to conduct a systematic review of publications from the past 20 years on the ocular and periorbital manifestations and complications of molluscum contagiosum (MC), as well as to discuss common diagnostic and therapeutic approaches.

Background: MC is a common skin infection with rare ocular manifestations. These presentations are primarily in children with atopic dermatitis (AD) and adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Though rare, ophthalmologists must recognize ocular manifestations early to prevent complications and reduce infection spread, particularly among immunocompromised individuals and pediatric patients.

Methods: We searched PubMed, SCOPUS, and Cochrane Library for studies on ocular and periorbital MC published between December 7, 2002 and December 7, 2022. English full-text articles on ocular MC were included, whereas systematic reviews and non-English texts were excluded. Generalized background information and statistical data were extracted from articles outside these criteria when necessary.

Results: AD was the most common risk factor in pediatric patients, whereas HIV/AIDS and immunocompromise were prevalent risk factors in adults. Lesions primarily presented on periorbital skin and eyelid margins, with rare ocular surface lesions. Excision and curettage were the most common treatments; while highly active antiretroviral therapy commonly resolved lesions for patients with HIV/AIDS. Secondary follicular conjunctivitis, the most frequent sequela, is often resolved with lesion removal.

Conclusions: MC may cause ocular surface, eyelid, and periorbital lesions, often leading to conjunctivitis. Regular skin examinations for pediatric patients with AD and vigilant childcare monitoring can limit transmission. Enhanced training for ophthalmologists on MC presentation and treatment is recommended.