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 Descemet’s 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, extensive cloudiness in the region of the original lesion, can occur as a result of natural healing, or possibly from an antigen-antibody reaction if VIG is administered.
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