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Correspondence |

The Ocular Complications of Smallpox and Smallpox Immunization

Janine A. Smith, MD; Christine G. Casey, MD; Bruce C. Tierney, MD
Arch Ophthalmol. 2004;122(9):1407. doi:10.1001/archopht.122.9.1407-a.
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The public health threat of smallpox reintroduction requires rapid disseminationof treatment guidelines for smallpox and smallpox (vaccinia) vaccine complications.The timely publication of 2 articles1,2 inthe ARCHIVES has introduced treatment options for ocular complications ofsmallpox and smallpox immunization.

Current guidelines for the treatment of vaccinia complications are basedpredominately on expert opinion because there are no controlled clinical studiesof the treatment of ocular vaccinia in humans and only limited controlledclinical studies of the treatment of ocular vaccinia in animal models. Becausethere is a paucity of data regarding the efficacy of treatment options forvaccinia complications, the Centers for Disease Control and Prevention (CDC),in November 2002, convened a panel of infectious disease, ophthalmology, epidemiology,and smallpox eradication experts to review the literature and to offer consultationregarding guidance to clinicians for the treatment of ocular vaccinia. Theserecommendations have been published.3

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