Monkeypox-associated keratitis and glabellar lesion mimicking a third eye

An early 30s man with a history of poorly controlled HIV/AIDS (diagnosed >15 years, CD4 count 15 cells/µL, HIV viral load 8,000 copies/mL, with self-reported non-adherence to bictegravir/emtricitabine/tenofovir (Bikatrvy)), neurosyphilis with prior ocular involvement, and a previous cytomegalovirus (CMV)-related rhegmatogenous retinal detachment of the left eye presented with 1 week of left eye purulent discharge, blurred vision, and a disseminated vesiculoulcerative rash ( figure 1A). He had no additional systemic comorbidities and denied recent travel, animal exposure, or known close contact with infected individuals.