{
  "abstract": "Background On 14 August 2024, the WHO redesignated Monkeypox (mpox) as a Public Health Emergency of International Concern. Ocular disease is under-recognised and can cause irreversible vision loss. Clarifying its burden, clade-specific patterns and HIV-related risks is essential for clinical care and public health.Methods We conducted an umbrella review and meta-analysis, systematically searching PubMed, Embase, Scopus, Web of Science and the Cochrane Library from inception to September 2025. Eligible studies were systematic reviews reporting ophthalmic manifestations in laboratory-confirmed mpox cases, stratified by viral clades I, II and IIb. Pooled proportions were estimated using random-effects meta-analysis, with clade-stratified subgroup analyses. The protocol was registered in PROSPERO (CRD420251137180).Results Five systematic reviews (36 primary studies; 28 139 patients) were included. The pooled proportion of conjunctivitis was 8.9% (95% CI 4.8 to 13.9), highest in clade I (21.9%) and lowest in clade IIb (2.7%). Keratitis (1.5%), eyelid lesions (3.3%), conjunctival lesions (8.4%) and corneal ulceration (3.3%) varied by clade. Visual impairment occurred in 4.5% overall; unilateral (0.9%) and bilateral (0.4%) blindness were reported only with clade I. Across reviews, people living with advanced HIV experienced disproportionately higher rates of severe and persistent ocular complications than HIV-negative individuals.Conclusions Mpox-related ophthalmic disease can cause substantial—and potentially preventable—visual disability. Clade I infection is associated with a greater burden of ocular complications than clade II—particularly IIb. Improved access to eye health services, early recognition and integration of HIV and mpox care are critical to reducing vision loss, especially in resource-limited settings.",
  "authors": [
    {
      "affiliations": [
        "Ophthalmology Department, Centre Médical de l’Alliance, Braine-l’Alleud, Walloon Brabant (Waals-Brabant), Belgium"
      ],
      "name": "Oscar Kallay"
    },
    {
      "affiliations": [
        "Centre Médical de l’Alliance, Brussels, Braine-I’Alleud, Belgium"
      ],
      "name": "Luxi Ji"
    },
    {
      "affiliations": [
        "Division of Health Sciences, Warwick Medical School, Coventry, England, UK"
      ],
      "name": "Olalekan A Uthman"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Edward J Mills"
    },
    {
      "affiliations": [
        "Division of Infection and Immunity, University College London, London, UK",
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Alimuddin Zumla"
    },
    {
      "affiliations": [
        "National Institute of Biomedical Research, Kinshasa, Congo (Democratic Republic of the)"
      ],
      "name": "Placide Mbala-Kingebeni"
    },
    {
      "affiliations": [
        "National Institute of Biomedical Research, Kinshasa, Congo (Democratic Republic of the)"
      ],
      "name": "Jean-Jacques Muyembe-Tamfum"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Erasmus Hospital, Brussels, Belgium"
      ],
      "name": "Elie Motulsky"
    },
    {
      "affiliations": [
        "Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA",
        "Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA",
        "Biomedical Research Institute (BMRI), Stellenbosch University Faculty of Medicine and Health Sciences (FMHS), Cape Town, South Africa"
      ],
      "name": "Jean B Nachega"
    }
  ],
  "title": "Clade-specific ophthalmic manifestations of mpox: an umbrella review and meta-analysis of systematic reviews",
  "uid": "bc0e34d3-1533-5090-a687-7b6c1a40e200"
}