{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T02:31:55Z","timestamp":1774405915768,"version":"3.50.1"},"reference-count":164,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Science and Technology for Emerging and Reemerging Viruses\u2014INCT-VER\/CNPq","award":["406360\/2022-7"],"award-info":[{"award-number":["406360\/2022-7"]}]},{"name":"National Institute of Science and Technology for Emerging and Reemerging Viruses\u2014INCT-VER\/CNPq","award":["308600\/2022-3"],"award-info":[{"award-number":["308600\/2022-3"]}]},{"name":"National Council for Scientific and Technological Development (CNPq)\/Brazil","award":["406360\/2022-7"],"award-info":[{"award-number":["406360\/2022-7"]}]},{"name":"National Council for Scientific and Technological Development (CNPq)\/Brazil","award":["308600\/2022-3"],"award-info":[{"award-number":["308600\/2022-3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Monkeypox virus (MPXV), belonging to the Poxviridae family and Orthopoxvirus genus, is closely related to the smallpox virus. Initial prodromal symptoms typically include headache, fever, and lymphadenopathy. This review aims to detail various ocular manifestations and immune evasion associated with the monkeypox viral infection and its complications, making it appropriate as a narrative review. Common external ocular manifestations of MPXV typically involve a generalized pustular rash, keratitis, discharges, and dried secretions related to conjunctival pustules, photophobia, and lacrimation. Orthopoxviruses can evade host immune responses by secreting proteins that antagonize the functions of host IFN\u03b3, CC and CXC chemokines, IL-1\u03b2, and the complement system. One of the most important transcription factors downstream of pattern recognition receptors binding is IRF3, which controls the expression of the crucial antiviral molecules IFN\u03b1 and IFN\u03b2. We strongly recommend that ophthalmologists include MPXV as part of their differential diagnosis when they encounter similar cases presenting with ophthalmic manifestations such as conjunctivitis, blepharitis, or corneal lesions. Furthermore, because non-vaccinated individuals are more likely to exhibit these symptoms, it is recommended that healthcare administrators prioritize smallpox vaccination for at-risk groups, including very young children, pregnant women, older adults, and immunocompromised individuals, especially those in close contact with MPXV cases.<\/jats:p>","DOI":"10.3390\/v15122301","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T11:31:25Z","timestamp":1700739085000},"page":"2301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Monkeypox Virus Immune Evasion and Eye Manifestation: Beyond Eyelid Implications"],"prefix":"10.3390","volume":"15","author":[{"given":"Francisco D.","family":"Lucena-Neto","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz F. M.","family":"Falc\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adolfo S.","family":"Vieira-Junior","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelly C. S.","family":"Moraes","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, Federal University of Par\u00e1, Bel\u00e9m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joacy P. F.","family":"David","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, Federal University of Par\u00e1, Bel\u00e9m 66075-110, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4444-2770","authenticated-orcid":false,"given":"Camilla C.","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge R.","family":"Sousa","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8540-6701","authenticated-orcid":false,"given":"Maria I. S.","family":"Duarte","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, S\u00e3o Paulo University, S\u00e3o Paulo 01246-904, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6603-5527","authenticated-orcid":false,"given":"Pedro F. C.","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6267-9966","authenticated-orcid":false,"given":"Juarez A. S.","family":"Quaresma","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, School of Medicine, State University of Par\u00e1, Bel\u00e9m 66087-670, PA, Brazil"},{"name":"Department of Infectious Disease, School of Medicine, Federal University of Par\u00e1, Bel\u00e9m 66075-110, PA, Brazil"},{"name":"Department of Infectious Disease, School of Medicine, S\u00e3o Paulo University, S\u00e3o Paulo 01246-904, SP, Brazil"},{"name":"Virology Section, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s10198-020-01206-8","article-title":"Historical evidence for economic effects of COVID-19","volume":"21","author":"Ceylan","year":"2020","journal-title":"Eur. J. 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